Haglund病的手术治疗体会

Surgical experience for treatment of Haglund's diseaseSurgical disease

背景：目前在Haglund病的治疗中，手术治疗指征及方法尚存在争议。目的：探讨应用带线锚钉重建跟腱止点治疗Haglund病的临床效果。方法：2009年1月至2013年11月我院收治Haglund病患者15例，其中男10例，女5例；年龄37~58岁，平均42.5岁。采用锚钉重建跟腱止点。术后进行临床及影像学随访，采用AOFAS踝-后足功能评分标准进行足踝部功能评估。结果：所有患者伤口均一期愈合，无皮肤坏死和切口周围麻木。术后随访6~22个月，平均15.8个月，末次随访AOFAS踝-后足功能评分为71~93分（平均83.6分）。其中优10足，良3足，可2足，优良率为86.7%。X线检查未见跟腱周围新生骨增生，MR提示跟腱愈合良好。结论：在严格掌握手术适应证的前提下，采用锚钉重建跟腱止点治疗Haglund病，手术操作简单，疗效确切，并发症少。但远期临床疗效仍需进一步观察。

Background：Indications and surgical methods for the treatment of Haglund＇s disease have been controversial. Objective：To investigate clinical outcomes of reconstructing Achilles dead with Mitck Mini anchor for Haglund＇s disease. Methods：Fifteen patients with Haglund＇s disease were treated by reconstructing Achilles dead with Mitck Mini anchor from January 2009 to November 2013 in our hospital. There were 10 males and 5 females with an mean age of 42.5 years （range, 37-58 years）. Postoperative Clinical examination and radiographic evaluation were conducted during follow-up. American Foot and Ankle Surgery Society （AOFAS） ankle-foot function score was used to evaluate clinical outcomes. Results：Primary healing was achieved in all wounds. No skin necrosis or numbness around the incision occurred. All Pa-tients were followed up for 15.8 months on average （range, 6-22 months）. Mean AOFAS ankle-hindfoot score was 83.6 （range, 71-93） at the last follow-up. Clinical examination was excellent in 10 cases, good in 3, and fair in 2. X-ray showed no proliferation of new bone around the Achilles tendon. MR results showed Achilles tendon was healed well. Conclusions：Reconstruction of Achilles dead with Mitck mini anchor is simple and effective for treatment of Haglund＇s dis-ease under proper surgical indications. However, long-term clinical efficacy should be investigated.