改良Zadek截骨治疗跟骨Haglund综合征
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1.河南中医药大学骨伤学院;2.郑州市骨科医院;3.河南中医药大学

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Modified zadek osteotomy for the treatment of Haglund syndrome
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1.College of orthopedics and traumatology, Henan University of traditional Chinese Medicine;2.Zhengzhou Orthopaedic Hospital;3.Henan University of traditional Chinese Medicine

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    摘要:

    摘 要:[目的]介绍改良Zadek背侧闭合楔形跟骨截骨术治疗Haglund综合征的手术技术和初步临床效果。[方法]2019年5月—2021年8月应用改良背侧闭合楔形跟骨截骨术治疗Haglund综合征12例。患者取健侧卧位,行跟腱前外侧纵行切口, 暴露跟腱止点以清除病变滑囊组织,并根据术前设计进行跟骨后上结节截骨及跟骨体楔形截骨。截骨后闭合楔形截骨区域,使跟腱止点向前上方旋转位移,改善跟腱功能,矫正畸形,两枚半螺纹空心钉闭合固定截骨,必要时增加克氏针临时固定。术后踝关节跖屈位支具固定保护。[结果]12例患者均顺利完成手术,无严重并发症。随访时间9~24个月。与术前相比,末次随访时,VAS评分,AOFAS踝-后足部评分及影像测量跟骨FPA角度均显著改善(P﹤0.05),根据Arner-Lindholm评分,优10例,良2例,优良率为100%(12/12)。[结论]采用改良术式治疗Haglund综合征,可有效缓解足跟疼痛,矫正跟骨结节后突畸形以及恢复踝关节功能。

    Abstract:

    Abstract: [Objective] To introduce the surgical technique and preliminary clinical effect of modified zadek dorsal closed wedge calcaneus osteotomy in the treatment of Haglund syndrome.[Methods] From May 2019 to August 2021, 12 cases of Haglund syndrome were treated with modified dorsal closed wedge calcaneal osteotomy. The patient took the healthy side lying position, made a longitudinal incision on the anterolateral side of the Achilles tendon, exposed the insertion point of the Achilles tendon to clear the pathological bursa, and performed the osteotomy of the posterior superior calcaneal tubercle and the wedge osteotomy of the calcaneal body according to the preoperative design. After osteotomy, the wedge-shaped osteotomy area was closed to rotate and displace the Achilles tendon stop forward and upward, improve the Achilles tendon function and correct the deformity. Two half thread hollow screws were used to close and fix the osteotomy, and when necessary, Kirschner wire was added for temporary fixation. After operation, the ankle joint was fixed and protected with plantar flexor brace.[Results] All the 12 patients completed the operation successfully without serious complications. The follow-up period was 9~24 months. Compared with before operation, VAS score, AOFAS ankle posterior foot score and calcaneal FPA angle measured by imaging were significantly improved at the last follow-up (P<0.05). According to Arner Lindholm score, 10 cases were excellent, 2 cases were good, and the excellent and good rate was 100% (12/12). [Conclusion] The treatment of Haglund syndrome with improved operation can effectively relieve heel pain,correct calcaneal tubercle retrogression deformity and restore ankle function.

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  • 收稿日期:2022-06-19
  • 最后修改日期:2022-09-07
  • 录用日期:2022-11-25
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