疼痛性跟距联合的治疗

Treatment of Painful Talocalcaneal Coalition

目的 :探讨疼痛性跟距联合手术治疗适应证及术式。方法 :根据术前跟距轴位CT扫描所测量的跟距联合与跟距后关节二者横向切面之比率及跟骨外翻角度来决定采取跟距骨桥局部切除或三关节融合术。共治疗 12例 16足 ,其中男 8例 ,女 4例。平均随访时间 18个月。结果 :术后根据患者症状消失程度分为优良、可、差。单纯行跟距联合切除者 9例 12足 ,其中优 6例 ,可 3例 ;三关节融合者 3例 4足 ,均为优良。结论 :经保守治疗无效者可行手术治疗 ,跟距联合与跟距后关节二者横向切面之比率 <5 0 % ,跟骨外翻角 <2 1°时可行跟距骨桥局部切除术 ,反之则应行三关节融合术。

Objective: To investigate the indications and the style of surgical operation for painful talocalcaneal coalition. Methods The resection of a talocalcaneal coalition or triple arthrodesis was selected according to calcaneal eversion angle and the rate of a talocalcaneal coalition and the posterior surface area of the talocalcaneal joint.16 feet in 12 patients including 8 males and 4 females were operated upon and reviewed at a mean time of 18 months. Results:Of 12 feet in 9 patients treated with resection of a talocalcaneal coalition,6 had excellent results,3 had good results.Of 4 feet in 3 patients,all were excellent.Conclusions:The indications for resection of a talocalcaneal coalition in clude failure of non-operative treatment,a coalition that is less than one-half of the posterior surface area of the talocalcaneal joint and the calcaneal eversion angle that is less than 21 degree.Otherwise.triple arthrodesis was performed.