跟距桥术后疼痛及功能改善的近期观察

Postoperative pain relief and functional improvement after surgery for talocalcaneal bridge

目的探讨跟距桥术后疼痛及功能的改善情况。方法使用磨钻对14例患者(16足)行跟距桥切除术。采用视觉模拟评分法(VAS)对患者术前、术后疼痛程度进行量化评分。测量踝关节活动度,评价患踝功能改善情况。结果 14例患者均获随访,时间3～6(4±0.2)个月。术前VSA评分(5.8±0.7)分,术后4个月降低至(1.1±0.6)分。距下关节内、外翻角度术前2°±0.6°和3°±0.5°,术后4个月提高至8.5°±0.9°和4.5°±0.2°。随访期内患者疼痛及踝关节的活动度明显改善。结论采用磨钻行跟距桥局部切除术,切口小,创伤小,恢复快,不影响跟距骨关节的正常着力点及稳定性,不改变足的生物力学结构。

Objective To study the postoperative pain relief and functional improvement after surgery for talocalcaneal bridge.. Methods 14 cases of 16 feet were enrolled. All cases were sited the taloealcaneal joint inner side with pain and vaius restriction. Talocalcaneal bridge of the 14 patients were resected by using grinding drill. Using visual analogue scales （VAS） in 14 patients with a preoperative and postoperative pain levels were quantified score. Ankle function improvement had been observed by measuring the ankle joint activity. Results 14 patients were followed up for 3 -6（4 ±0. 2） months. The VAS sco±res was reduced to postoperative 1.1±0. 6 points from preoperative 5. 8 ± 0. 7 points. The subtalar joint varus and valgus angles were respectively increased from the preoperative 2° ± 0. 6° and 3°±0. 5° to the 8.5°±0. 9° and 4. 5°± 0. 2° after 4 months. The pain and ankle activity were markedly improved in the follow-up period. Conclusions Using a grinding drill for local excision of talocalcaneal bridge is with small incision,less trauma, quicker recovery, which does not affect the normal subtalar joints on its stability, and does not change the biomechanics of the foot structure.