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针对伴有Haglund畸形的跟腱附着点炎的外侧入路

Lateral approach for insertional Achilles tendinitis with Haglund deformity.

作者信息

Jiang Jiantao, Wang Cheng, Fu Shaoling, Wang Jiazheng, Wu Chenglin, Yao Guangxiao, Song Guoxun, Gu Wenqi, Yang Kai, Xue Jianfeng, Shi Zhongmin

机构信息

Department of Orthopaedic Surgery, Shaoxing Shangyu Traditional Chinese Medicine Hospital, Zhejiang, China.

Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai, China.

出版信息

Front Surg. 2023 Jan 6;9:1063833. doi: 10.3389/fsurg.2022.1063833. eCollection 2022.

Abstract

OBJECTIVE

The study aims to investigate the functional outcome of the lateral approach for insertional Achilles tendinitis (IAT) with Haglund deformity.

METHODS

From January 2016 to September 2019, 14 cases of IAT with Haglund deformity that resisted conservative treatment received surgery in our department. A lateral approach was used to debride the bony and soft tissue and reattach the insertion of the Achilles tendon. The Visual Analog Scale (VAS), American Orthopedic Foot and Ankle Score (AOFAS), and Victorian Institute of Sport Tendon Study Group-Achilles Tendinopathy score (VISA-A) were used to evaluate clinical outcomes.

RESULT

The mean patient age was 39.57 years at the time of surgery. The mean follow-up was 14.74 months. The mean VAS score significantly decreased from 4.86 ± 0.86 preoperatively to 1.21 ± 1.58 postoperatively ( < 0.001). The mean AOFAS score significantly improved from 66.64 ± 6.23 preoperatively to 90.21 ± 11.50 postoperatively ( < 0.001). The mean preoperative and the last follow-up VISA-A were 66 (range 56.75-69.25) and 86 (range 75.75-97.00) points, respectively ( < 0.05).

CONCLUSION

The lateral approach was effective and safe for IAT with Haglund deformity. Moreover, the mid-term functional outcome was promising.

LEVEL OF CLINICAL EVIDENCE

IV.

摘要

目的

本研究旨在探讨外侧入路治疗伴有Haglund畸形的跟腱附着点炎(IAT)的功能结局。

方法

2016年1月至2019年9月,我科对14例经保守治疗无效的伴有Haglund畸形的IAT患者进行了手术。采用外侧入路清理骨组织和软组织,并重新附着跟腱附着点。采用视觉模拟评分法(VAS)、美国矫形足踝协会评分(AOFAS)和维多利亚运动肌腱研究组跟腱病评分(VISA-A)评估临床结局。

结果

手术时患者平均年龄为39.57岁。平均随访14.74个月。VAS评分均值从术前的4.86±0.86显著降至术后的1.21±1.58(<0.001)。AOFAS评分均值从术前的66.64±6.23显著提高至术后的90.21±11.50(<0.001)。术前VISA-A评分均值和末次随访时分别为66分(范围56.75 - 69.25)和86分(范围75.75 - 97.00)(<0.05)。

结论

外侧入路治疗伴有Haglund畸形的IAT有效且安全。此外,中期功能结局良好。

临床证据等级

IV级

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd4c/9852719/47483b2c1257/fsurg-09-1063833-g001.jpg

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