Harper M C, Tisdel C L
Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Ohio 44195, USA.
Foot Ankle Int. 1996 Nov;17(11):658-61. doi: 10.1177/107110079601701102.
Twenty-seven consecutive patients with posterior tibial tendon insufficiency were treated with talonavicular arthrodesis as the primary stabilizing procedure. Twenty-six patients were followed a minimum of 12 and an average of 27 months. Twenty-four patients had either no pain or pain only after heavy usage. Eleven patients were completely satisfied with postoperative foot function, 13 were satisfied, with minor reservations, and 2 were satisfied, with major reservations. Results were rated as excellent in 10 patients, good in 14 patients, and fair in 2 patients. Successful arthrodesis was achieved in all patients, although one patient required two additional bone grafts. Progressive arthrosis in adjacent joints was noted in five patients, four of whom had arthrosis preoperatively. No deterioration of foot position was seen in any patient with follow-up as long as 5 years. An isolated talonavicular arthrodesis seems to offer patients with this disorder both reliable pain improvement and lasting stability.
连续27例胫后肌腱功能不全患者接受距舟关节融合术作为主要稳定手术。26例患者接受了至少12个月、平均27个月的随访。24例患者无痛或仅在大量活动后疼痛。11例患者对术后足部功能完全满意，13例满意但有轻微保留意见，2例满意但有较大保留意见。结果评为优10例，良14例，可2例。所有患者均成功实现关节融合，尽管有1例患者需要额外进行两次植骨。5例患者出现相邻关节进行性关节病，其中4例术前就有关节病。随访长达5年的所有患者均未出现足部位置恶化。单纯距舟关节融合术似乎能为患有这种疾病的患者带来可靠的疼痛改善和持久的稳定性。
