跟舟联合的诊断与治疗新进展

Progress in Diagnosis and Treatment of the Calcaneonavicular Coalition

跟舟联合是跟骨与舟骨之间形成的畸形连接,主要有骨、软骨、纤维性联合3种存在形式。目前主流观点认为:跟舟联合是由于胚胎期间质细胞分化失败的结果。普通X线后足45°斜位片有利于跟舟联合的诊断,电子计算机断层扫描(CT)及磁共振成像(MRI)影像学检查,对跟舟联合的性质鉴别有重大价值。非甾体类抗炎药及短腿石膏固定等保守治疗可有效缓解跟舟联合症状,而保守治疗失败患者可经传统开放手术或微创手术治疗。本文通过查阅相关文献,对跟舟联合的病因学、诊断及治疗方法进行总结分析,以增强临床医师对跟舟联合的认识,提高诊断率。

The calcaneonavicular coalition is a malformed condition between calcaneus and navicular. There are three forms of coalition: bone, cartilage and fibrous.At present, the mainstream view is that the calcaneonavicular coalition is the result of the differentiation failure of mesenchymal cells during the embryo. The 45° oblique radiographic view of hind foot is conducive to the diagnosis of calcaneonavicular coalition.Computed tomography(CT) scan and magnetic resonance imaging(MRI) are of great value in the identification of coalition.Conservative treatment, such as non-steroidal anti-inflammatory drugs(NSAIDs) and short leg cast, can effectively relieve the symptoms of calcaneonavicular coalition, and patients who failed in conservative treatment can be treated by traditional open operation and minimally invasive surgery. By consulting the relevant literature, we reviewed the etiology, diagnosis and treatment of the calcaneonavicular coalition, so as to enhance the clinicians’ understanding and improve the diagnostic rate.