Luo Yang, Qi Wei, Wei Min
Department of Orthopaedics, General Hospital of PLA, Beijing 100853, China.
Zhongguo Gu Shang. 2021 May 25;34(5):448-51. doi: 10.12200/j.issn.1003-0034.2021.05.010.
To evaluate clinical efficacy of modified kidner procedure with tendoscopy in treating painful accessory navicular.
From February 2014 to April 2019, 19 patients with painful accessory navicular were admitted, including 13 males and 6 females with a mean age of 26 years old (ranged from 14 to 58 years old), all of which were unilateral symptoms. The courses of disease ranged from 6 to 60 months. All patients received excision of accessory navicular and reconstruction of posterior tibial tendon insertion on navicular with anchor, and the tendoscopy were used to examin the posterior tibial tendon. American Orthopedic Foot and Ankle Society(AOFAS) midfoot score and visual analogue scale(VAS) were used to evaluate efficacy before operation and at the latest follow-up.
All the patientswere followed up, and the duration ranged from 12 to 73 months, with an average of (35.0±20.9) months. VAS score was 0.20±0.41 at the latest follow-up, showing significant difference when compared with preoperative score of 6.33±1.95(=11.50, <0.01). AOFAS score was 95.53±5.79 at the latest follow-up, showing significant difference when compared with preoperative score of 60.27±21.51 (=5.71, <0.01).
The modified kidner procedure with tendoscopy is a good choice for the treatment of painful accessory navicular, which could obviously relieve foot pain, improve foot function, and has certain clinical efficacy.
评估改良Kidner手术联合关节镜治疗疼痛性副舟骨的临床疗效。
选取2014年2月至2019年4月收治的19例疼痛性副舟骨患者,其中男13例,女6例,平均年龄26岁(14~58岁),均为单侧发病。病程6~60个月。所有患者均接受副舟骨切除及用锚钉重建胫后肌腱在舟骨上的止点,并采用关节镜检查胫后肌腱。采用美国矫形足踝协会(AOFAS)中足评分和视觉模拟评分(VAS)对手术前及末次随访时的疗效进行评估。
所有患者均获随访,随访时间12~73个月,平均(35.0±20.9)个月。末次随访时VAS评分为0.20±0.41,与术前评分6.33±1.95比较差异有统计学意义(t=11.50,P<0.01)。末次随访时AOFAS评分为95.53±5.79,与术前评分60.27±21.51比较差异有统计学意义(t=5.71,P<0.01)。
改良Kidner手术联合关节镜是治疗疼痛性副舟骨的较好选择,可明显缓解足部疼痛,改善足部功能,具有一定的临床疗效。