Treatment of stage II posterior tibial tendon dysfunction with flexor hallucis longus transfer and medial displacement calcaneal osteotomy
Treatment of stage II posterior tibial tendon dysfunction with flexor hallucis longus transfer and medial displacement calcaneal osteotomy
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DOI：
10.1177/107110070102200406
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发表时间：
2001-04-01
影响因子：
2.7
通讯作者：
Hockenbury, RT
中科院分区：
文献类型：
--
作者：
Sammarco, GJ;Hockenbury, RT
连续19例患者接受了拇长屈肌腱（FHL）转移和内侧移位跟骨截骨术治疗2期胫骨后肌腱功能障碍。FHL肌腱被用于转移，因为它接近胫骨后肌的强度，并且比腓骨短肌更强。17例患者返回进行随访检查，随访时间18个月（平均）。AOFAS后足评分从62.4/100改善至83.6/100。AOFAS后足评分的主观部分从31.0160.0改善至48.9160。负重术前和术后X线片显示，在测量外侧距骨-第一跖骨角、跟骨间距、从地板到内侧楔形骨的垂直距离或距舟覆盖角方面，内侧纵弓没有统计学显著改善。术后，3只足的内侧纵弓正常，6只足的纵弓与对侧相似。患者满意度高：10例患者满意，无保留，6例患者满意，有轻微保留，1例不满意。没有病人抱怨从收获的FHL肌腱供体缺陷。尽管该手术无法改善内侧纵弓的高度，但FHL转移联合内侧移位跟骨截骨术获得了良好至极佳的临床结果和较高的患者满意度。
Nineteen consecutive patients underwent flexor hallucis longus (FHL) tendon transfer and medial displacement calcaneal osteotomy for the treatment of Stage 2 posterior tibial tendon dysfunction. The FHL tendon was utilized for transfer because it approximates the strength of the posterior tibialis muscle and is stronger than the peroneus brevis muscle. Seventeen patients returned for follow-up examination, follow-up time 18 months (ave.). The AOFAS hindfoot score improved from 62.4/100 to 83.6/100. The subjective portion of the AOFAS hindfoot score improved from 31.0160.0 to 48.9160. Weightbearing preoperative and postoperative radiographs revealed no statistically significant improvement for the medial longitudinal arch in measurements of lateral talo-first metatarsal angle, calcaneal pitch, vertical distance from the floor to the medial cuneiform, or talonavicular coverage angle. Three feet had a normal medial longitudinal arch and six feet had a longitudinal arch similar to the opposite side following the procedure. Patient satisfaction was high: 10 patients satisfied without reservations, 6 patients satisfied with minor reservations, and 1 dissatisfied. No patient complained of donor deficit from the harvested FHL tendon. Despite the inability of the procedure to improve the height of the medial longitudinal arch, FHL transfer combined with medial displacement calcaneal osteotomy yielded good to excellent clinical results and a high patient satisfaction rate.