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拇趾下垂的评估与手术修复综述

Review of Drop Hallux: Assessment and Surgical Repair.

作者信息

Kihm Carl A, Camasta Craig A

机构信息

Faculty, The Podiatry Institute, Decatur, GA, and Private Practice, Marietta, GA.

Program Director, Pediatric and Adult Foot and Ankle Fellowship, VPC/EHI, Atlanta, GA; Podiatry Section Chief, St. Joseph's Hospital of Atlanta, Atlanta, GA; and Private Practice, Atlanta, GA.

出版信息

J Foot Ankle Surg. 2017 Jan-Feb;56(1):103-107. doi: 10.1053/j.jfas.2016.08.001.

Abstract

Peroneal nerve palsy is common. The hallmark clinical manifestation of peroneal nerve palsy is drop foot. In the drop foot condition, the ankle cannot flex, and the foot does not clear the ground during the swing phase of gait. Spontaneous nerve repair can yield complete or incomplete resolution of drop foot. Some patients with incomplete resolution are left with a drop hallux condition, in which the ankle can dorsiflex, but the hallux remains unable to dorsiflex. This has not been thoroughly discussed in the past, regarding surgical repair. In the present report, we have reviewed the drop hallux condition and an effective surgical repair option (extensor hallucis longus to tibialis anterior tendon anastomosis). Our case report presents a healthy 27-year-old male who had persistent drop hallux after drop foot resolution, 3 years after external fixation of a closed, proximal tibia-fibula fracture.

摘要

腓总神经麻痹很常见。腓总神经麻痹的标志性临床表现是足下垂。在足下垂状态下,踝关节无法背屈,在步态摆动期足部无法离地。神经自发修复可使足下垂完全或部分缓解。一些未完全缓解的患者会遗留拇趾下垂的情况,即踝关节能够背屈,但拇趾仍无法背屈。过去关于手术修复,对此尚未进行过充分讨论。在本报告中,我们回顾了拇趾下垂的情况以及一种有效的手术修复方法(拇长伸肌腱与胫前肌腱吻合术)。我们的病例报告介绍了一名27岁的健康男性,在闭合性胫腓骨近端骨折外固定3年后,足下垂缓解后仍持续存在拇趾下垂。

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