临床误诊误治2026，Vol.39Issue(3)：46-52,7.DOI:10.3969/j.issn.1002-3429.2026.03.008
改良式胫骨后肌腱重建术治疗Ⅱ型痛性副舟骨的临床效果及安全性
Clinical efficacy and safety of modified tibialis posterior tendon reconstruction in the treatment of type Ⅱ painful accessory navicular bone
摘要
Abstract
Objective To investigate the clinical efficacy and surgical safety of modified tibialis posterior tendon reconstruction in the treatment of type Ⅱ painful accessory navicular bone.Methods A total of 61 patients with type Ⅱ painful accessory navicular bone who were admitted from August 2021 to August 2023 were retrospectively included.According to the surgical methods adopted by the patients,they were divided into two groups,Group A and Group B.Group A was treated with modified tibialis posterior tendon reconstruction(excision of the accessory navicular bone and reconstruction of the posterior tibial tendon with suture anchors),while Group B underwent Kidner surgery.The preoperative and final follow-up scores of the American Orthopedic Foot and Ankle Society(AOFAS)midfoot scale,the Visual Analogue Scale(VAS)pain score,and radiographic parameters were compared between the two groups.The serum inflammatory indicators at 3 d after surgery and the time to complete weight-bearing after surgery were also compared,and the occurrence of complications was observed.Results The postoperative follow-up period for all patients ranged from 12.1 to 18.8(15.6±3.1)months,with no patients lost to follow-up.At the end of the follow-up,the VAS pain scores of both groups were lower than those before surgery,and the AOFAS midfoot scale score was higher than that before surgery.The calcaneal pitch angle,talar tilt angle,talo-first metatarsal angle,anteriorposterior talo-first metatarsal angle,and talonavicular coverage angle all improved compared with those before the surgery(P<0.05).Before the surgery and at the end of the follow-up,there was no significant difference in VAS pain score,AOFAS midfoot scale score,and radiographic parameters between the two groups(P>0.05).At 3 d after the surgery,there was no significant difference in serum C-reactive protein,interleukin-1β,interleukin-6,and tumor necrosis factor-α levels between the two groups(P>0.05).The postoperative complete weight-bearing time of group A was(12.00±1.00)weeks,which was shorter than that of group B[(13.00±1.64)weeks](P<0.05).Neither group had nerve or vascular injuries.Except for one case in group B that developed incision infection on the 7th day after the surgery,all incisions healed smoothly.Conclusion The modified tibialis posterior tendon reconstruction,as well as the traditional Kidner surgery for treating type Ⅱ painful accessory navicular bones,can all alleviate the pain symptoms of patients and improve the function of the affected foot,showing high surgical safety.However,the complete weight-bearing time of the former is shorter than that of the latter,and it has certain advantages.关键词
Ⅱ型痛性副舟骨/胫骨后肌腱/肌腱重建/疼痛/安全性/足功能Key words
type Ⅱ painful accessory navicular bone/posterior tibial tendon/tendon reconstruction/pain/safety/foot function引用本文复制引用
张亚兴,刘斌,王艳涛,蒲晓鹏,康强军..改良式胫骨后肌腱重建术治疗Ⅱ型痛性副舟骨的临床效果及安全性[J].临床误诊误治,2026,39(3):46-52,7.基金项目
2026年度河北省医学科学研究课题计划项目(20261426) （20261426）
