Ballal Moez S, Roche Andy, Brodrick Anna, Williams R Lloyd, Calder James D F
Foot and Ankle Fellow, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Consultant Trauma and Orthopaedic Surgeon, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
J Foot Ankle Surg. 2016 Sep-Oct;55(5):927-30. doi: 10.1053/j.jfas.2016.04.006. Epub 2016 Jun 8.
Previous studies have compared the outcomes after open and endoscopic excision of an os trigonum in patients of mixed professions. No studies have compared the differences in outcomes between the 2 procedures in elite ballet dancers. From October 2005 to February 2010, 35 professional ballet dancers underwent excision of a symptomatic os trigonum of the ankle after a failed period of nonoperative treatment. Of the 35 patients, 13 (37.1%) underwent endoscopic excision and 22 (62.9%) open excision. We compared the outcomes, complications, and time to return to dancing. The open excision group experienced a significantly greater incidence of flexor hallucis longus tendon decompression compared with the endoscopic group. The endoscopic release group returned to full dance earlier at a mean of 9.8 (range 6.5 to 16.1) weeks and those undergoing open excision returned to full dance at a mean of 14.9 (range 9 to 20) weeks (p = .001). No major complications developed in either group, such as deep infection or nerve or vessel injury. We have concluded that both techniques are safe and effective in the treatment of symptomatic os trigonum in professional ballet dancers. Endoscopic excision of the os trigonum offers a more rapid return to full dance compared with open excision.
以往的研究比较了不同职业患者行跗三角骨开放切除术和内镜下切除术的疗效。尚无研究比较这两种手术方式在优秀芭蕾舞演员中的疗效差异。2005年10月至2010年2月,35名职业芭蕾舞演员在非手术治疗失败后接受了有症状的跗三角骨切除术。35例患者中,13例(37.1%)接受了内镜下切除术,22例(62.9%)接受了开放切除术。我们比较了疗效、并发症以及恢复舞蹈的时间。与内镜组相比,开放切除组拇长屈肌腱减压的发生率显著更高。内镜松解组平均在9.8周(范围6.5至16.1周)更早恢复全面舞蹈,而接受开放切除术的患者平均在14.9周(范围9至20周)恢复全面舞蹈(p = 0.001)。两组均未出现深部感染、神经或血管损伤等严重并发症。我们得出结论,两种技术在治疗职业芭蕾舞演员有症状的跗三角骨方面都是安全有效的。与开放切除术相比,内镜下切除跗三角骨能更快恢复全面舞蹈。