两种修复方法治疗腓骨肌腱滑脱症的临床对照研究

Clinical Comparative Study of two Methods in the Treatment of Peroneal Tendon Dislocation

目的对比腓骨钻孔缝合固定和带线锚钉缝合固定两种方式修复腓骨肌上支持带对治疗腓骨肌腱滑脱症的手术疗效。方法自2016年10月至2018年8月对26例腓骨肌腱滑脱症患者进行手术治疗,依据修复固定方式不同分为两组。12例患者行腓骨钻孔缝合修复腓骨肌上支持带,14例患者行带线锚钉缝合修复腓骨肌上支持带。两组患者在性别、年龄、损伤侧别、损伤原因比较差异无统计学意义(P>0.05)。采用美国足踝外科协会(American orthopaedic foot and ankle society,AOFAS)踝-后足评分、视觉模拟评分(visual analogue scale,VAS)评估术前和术后至少9个月的临床随访结果。此外,比较各组手术时间、术中出血、手术费用数据。采用SPSS18.0软件进行统计学处理,各项统计数据采用t检验进行统计学分析,P<0.05表示差异具有统计学意义。结果所有患者术后随访9~12个月,平均(10.23±1.18)个月。两组术后随访的VAS评分及AOFAS评分比较,差异无统计学意义(P>0.05)。两组在手术时间、术中出血、手术费用方面的比较差异均有统计学意义(P<0.05)。结论腓骨钻孔缝合修复或带线锚钉缝合修复腓骨肌上支持带,均在手术治疗腓骨肌腱滑脱症中取得了良好的效果,两者在治疗效果上无差异,但在手术时间、术中出血方面带线锚钉固定方式明显优于腓骨钻孔缝合。在手术费用方面,腓骨钻孔缝合有一定的优势。

Objective To compare the surgical effect of fibula drilling suture fixation and suture fixation with suture anchor in the treatment of peroneal tendon dislocation.Methods 26 patients with peroneal tendon dislocation were treated with surgery from October 2016 to August 2018,and these patients were divided into two groups according to different fixation and repair ways.Fibula drilling suture fixationon the superior peroneal retinaculum(SPR)was uesed in 12 patients and suture fixationon with suture anchor wasused in another 14 patients.There was no significant difference in gender,age,injury side and injury cause between the two groups(P>0.05).The AOFAS(American orthopaedic foot and ankle society)score and VAS(visual analogue scale)score were recorded at preoperative and minimal 9-month of follow-up.In addition,the operative time,intraoperative bleeding and surgical costs were compared.SPSS18.0 soft ware was used for statistical processing,and the statistical data were analyzed by t-test,with P<0.05 indicating that the difference was statistically significant.Results All patients were followed up for 9 to 12 months,with an average of(10.23±1.18)months.There were no significant differences in the compare of VAS score and AOFAS score postoperative between the two groups(P>0.05).There were significant differences in operative time,bleeding,and cost between the two groups(P<0.05).Conclusion Both fibula drilling suture fixation and suture fixation with suture anchorto repairthe superior peroneal retinaculum(SPR)have excellent effect in surgical treatment of peroneal tendon dislocation.There are no difference in the two treatment,but the fibula drilling suture fixationhas obviously advantage in terms of the operative time and intraoperative bleeding.And in terms of operation cost,the method of suture fixation with suture anchor has certain advantages.