Strayer、Baumann和Vulpius术式对非痉挛性腓肠肌挛缩松解的效果比较

Comparison of the effect of Strayer, Baumann and Vulpius procedure for the non-spastic gastrocnemius contraction

目的比较Strayer、Baumann和Vulpius三种腓肠肌松解术式对非痉挛性腓肠肌挛缩松解的效果。方法对21例正常成年人带膝小腿标本行腓肠肌松解术，分别采用Strayer、Baumann和Vulpius术式，每组各7例，观察并比较各组在膝关节伸直和屈曲状态下腓肠肌断端拉伸距离、踝关节背伸角度变化和胫跟夹角角度变化。结果膝关节伸直状态下，断端拉伸距离：Strayer与Baumann术式、Baumann与Vulpius术式比较，差异均有统计学意义，Strayer与Vulpius术式差异无统计学意义，故Strayer术式的拉伸距离较Baumann术式长，但和Vulpius术式无明显区别；踝关节背伸角度变化：Stayer与Baumann术式、Baumann与Vulpius术式、Strayer与Vulpius术式比较，差异均有统计学意义，且Strayer的背伸角度变化最大；胫跟夹角角度变化：Strayer与Baumann术式、Strayer与Vulpius术式比较，差异均有统计学意义，Baumann与Vulpius术式差异无统计学意义，且Strayer术式的角度变化最大。膝关节屈曲状态下，断端拉伸距离：Strayer与Baumann术式、Strayer与Vulpius术式比较，差异均有统计学意义，Baumann与Vulpius术式差异无统计学意义，且Strayer术式的拉伸距离最长；踝关节背伸角度变化：Stayer与Baumann术式、Baumann与Vulpius术式、Strayer与Vulpius术式比较，差异均有统计学意义，且Strayer术式的背伸角度变化最大；胫跟夹角角度变化：Strayer与Banmann术式、Strayer与Vulpius术式比较差异均有统计学意义，Baumann与Vulpius术式差异无统计学意义，且Strayer术式的角度变化最大。结论采用Strayor、Baumann和Vulpius三种腓肠肌松解术式对非痉挛性腓肠肌挛缩松解效果进行比较，结果发现Strayer术式对腓肠肌的松解效果更为明显，腓肠肌拉伸距离更长，踝关节背伸和胫跟夹角角度变化较大，值得推荐。

Objective To compare the effect of Strayer, Baumann and Vulpius procedure for non-spastic gastrocnemius muscle through the anatomical study of specimens of normal body. Methods The gastrocnemius muscle of 21 cases of normal adults calf leg samples with knee was released （7 with Strayer procedure, 7 with Baumann procedure and 7 with Vulpius procedure）. The stretching distance of the broken ends, the maximum extension angle of the ankle joint and the angle between the tibia and the calcaneal were measured and compared when the knee was extended and flexed. Results When the knee was extended, the stretching distance of the broken ends had statistical differences between Strayer and Baumann, Baumann and Vulpius, and there was no statistical difference between Strayer and Vulpiu. The maximum extension angle of the ankle joint had statistical differences between Strayer, Baumann and Vulpius; the angle between the tibia and the calcaneal had statistical differences between Strayer and Baumann, Strayer and Vulpius, and there was no significant statistical difference between Baumann and Vulpius. When the knee was flexed, the stretching distance of the broken ends had statistical differences between Strayer and Baumann, Strayer and Vulpius, and there was no statistical difference between Baumann and Vulpius; the maximum extension angle of the ankle jointhad statistical differences between Strayer, Baumann and Vulpius; the angle between the tibia and the calcaneal had statistical differences between Strayer and Baumann, Strayer and Vulpius, and there was no significant statistical difference between Baumann and Vulpius. Conclusion By comparing the results of the three kinds of surgical methods, it shows that the effect of Strayer approach for gastrocnemius muscle recession is most obvious.