TwinFix锚钉胫后肌腱重建术治疗成人足副舟骨疼痛综合征并发症发生原因及防治策略OA
Analysis of Causes and Prevention Strategies of Complications for Adult Patients with Painful Accessory Navicular Pain Syndrome Treated with Posterior Tibial Tendon Reconstruction Using TwinFix Anchor
目的 探讨TwinFix锚钉胫后肌腱重建手术治疗成人足副舟骨疼痛综合征并发症发生的原因及防治策略.方法 回顾性分析2013 年1 月至2023 年1 月行TwinFix锚钉胫后肌腱重建术治疗的成人足副舟骨疼痛综合征出现并发症的32 例的临床资料.结果 32 例中发生术后疼痛12 例(37.5%),其中,切口、切口周围及足内侧其他区域疼痛10 例,锚钉误入关节及钉尾外露刺激皮肤各1 例,经过抗感染、消肿、止痛等对症治疗或手术翻修治疗后,症状均缓解;发生周围神经损伤相关足底麻木5 例(15.6%),行消肿和营养神经对症治疗,症状好转;术后切口感染、皮肤坏死3 例(9.4%),经抗感染治疗并行切口扩创手术后,感染得到控制,切口痊愈;足部功能受限 9 例(28.1%),经康复锻炼,症状缓解;锚钉脱出3 例(9.4%),经二次手术翻修和康复锻炼后,患者病情均好转.术后12 个月,美国足与踝关节协会踝-后足功能评分[(86.03±4.83)分]均较术前[(49.34±8.41)分]显著改善(P＜0.01).结论 Twin-Fix锚钉胫后肌腱重建术治疗成人足副舟骨疼痛综合征可发生症状相关并发症及术后功能改善不良相关并发症,与手术时间长、操作粗暴、锚钉脱出等有关,术中应仔细操作,尽量缩短手术时间,术后对出现的并发症积极处理,可避免严重后果.
Objective To investigate the causes and prevention strategies of complications in the treatment of adult patients with painful accessory navicular syndrome treated with posterior tibial tendon reconstruction using TwinFix anchor.Methods The clinical data of 32 adult patients with painful accessory navicular syndrome who underwent posterior tibial ten-don reconstruction using TwinFix anchor from January 2013 to January 2023 were retrospectively analyzed.Results Postoper-ative pain occurred in 12 of the 32 patients(37.5%),including pain in the incision,around the incision and other areas of the medial foot in 10 patients,and the anchor strapping into the joint and the exposed nail tail irritating the skin in 1 patient respectively.After symptomatic treatment such as anti-infection,detumescence,pain relief or surgical revision treatment,the symptoms were relieved.Peripheral nerve injury-related plantar-numbness occurred in 5 patients(15.6%),and the symp-toms were improved after symptomatic treatment including detumescence and nutritional nerve.Postoperative incision infection and skin necrosis were found in 3 patients(9.4%).The infection was controlled and the incision healed after anti-infection treatment and incision expansion surgery.There were9 patients(28.1%)with limited foot function,and symptoms were re-lieved after rehabilitation exercise.There were3 patients(9.4%)of anchor loss.After the second operation and rehabilita-tion exercise,the patients'condition improved.At 12 months after operation,AOFAS ankle-posterior foot function score[(86.03±4.83)points]was significantly improved compared with that before operation[(49.34±8.41)points](P＜0.01).Conclusion Posterior tibial tendon reconstruction using TwinFix anchor in the treatment of adult patients with painful accessory navicular syndrome can cause symptom-related complications and complications related to poor postoperative function improvement,which are related to long duration of operation,rough operation and anchor loss.Careful operation should be performed during the the procedure to shorten the duration of operation as much as possible,and postoperative complications should be actively managed to avoid serious consequences.
王宇清;金瑞娜;康强军
050082 石家庄,联勤保障部队第九八〇医院骨三科050082 石家庄,联勤保障部队第九八〇医院骨三科050082 石家庄,联勤保障部队第九八〇医院骨三科
临床医学
疼痛性副舟骨TwinFix锚钉胫后肌腱重建术手术后并发症感染疼痛神经损伤AOFAS踝-后足功能
Painful accessory navicularTwinFix anchorPosterior tibial tendon reconstructionPostoperative com-plicationsInfectionPain,Nerve injuryAOFAS ankle-posterior foot function
《临床误诊误治》 2025 (6)
55-59,67,6
联勤保障部队战勤部面上项目(CLB19J044)
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