Xie Bing, Yan Shuo, Zhang Hao, Wang Yuan-Wei, Tian Jing
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China.
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China;
Zhongguo Gu Shang. 2017 Nov 25;30(11):1048-1051. doi: 10.3969/j.issn.1003-0034.2017.11.016.
To analyze clinical outcomes of osseous-bridge resection for the treatment of adult symptomatic talocalcaneal coalitions without arthritis.
The clinical data of 12 patients (15 feet) with symptomatic talocalcaneal coalitions without arthtitis from January 2013 to June 2016 were respectively analyzed. All cases were secondary talocalcaneal coalition. There were 9 males (11 feet) and 3 females (4 feet) with a mean (26.6±3.3) years old (ranged, 18 to 33 years old). According to the Rozansky classification, there were 4 (6 feet) type I, 3 (3 feet) type II, 2 (2 feet) type III, 1 (1 feet) type IV, and 2 (3 feet) type V. All patients received coalition resection and interposition of fat graft. Complication, recurrence and range of motion was regularly recorded after operation. Clinical efficacy was evaluated according to the visual analogue scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot scale.
All patients were followed up for an average duration of (28.7±18.3) months (ranged, 12 to 48 months). All the incisions were primarily healed. There were no wound necrosis, infection, neurovascular or tendon injuries. Range of motion was improved in 13 feet. All patients returned back to work. Recurrence happened in 1 case 2 years after surgery, the patient received a secondary coalition resection. At the latest follow-up, VAS was 2.1±0.8 and AOFAS score was 82.7±7.2, were siginificantly improved when compared with the preoperative scores(8.2±0.7, =6.233, <0.01; 48.4±6.8, =5.747, <0.01).
For adult patients with symptomatic talocalcaneal coalitions without arthritis, simple coalition resection could provide good clinical outcomes with minimal complications.
分析骨桥切除术治疗无关节炎的成年有症状距下关节联合症的临床疗效。
回顾性分析2013年1月至2016年6月收治的12例（15足）无关节炎的有症状距下关节联合症患者的临床资料。所有病例均为继发性距下关节联合症。其中男性9例（11足），女性3例（4足），平均年龄（26.6±3.3）岁（范围18～33岁）。按照Rozansky分类法，Ⅰ型4例（6足），Ⅱ型3例（3足），Ⅲ型2例（2足），Ⅳ型1例（1足），Ⅴ型2例（3足）。所有患者均接受了联合症切除术及脂肪移植填充。术后定期记录并发症、复发情况及活动度。根据视觉模拟评分法（VAS）和美国足踝外科协会（AOFAS）踝后足评分评估临床疗效。
所有患者平均随访（28.7±18.3）个月（范围12～48个月）。所有切口均一期愈合，无伤口坏死、感染、神经血管或肌腱损伤。13足活动度改善。所有患者均恢复工作。1例患者术后2年复发，再次接受了联合症切除术。末次随访时，VAS为2.1±0.8，AOFAS评分为82.7±7.2，与术前评分（8.2±0.7，t =6.233，P<0.01；48.4±6.8，t =5.747，P<0.01）相比均显著改善。
对于无关节炎的成年有症状距下关节联合症患者，单纯联合症切除术可提供良好的临床疗效，并发症少。
