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Surgery for Retrocalcaneal Bursitis: A Tendon-splitting versus a Lateral Approach

机译:跟骨后囊炎的手术:肌腱劈裂与侧向入路

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摘要

For patients with refractory retrocalcaneal bursitis (Haglund’s syndrome), the most effective surgical approach has not been defined. We asked whether patients undergoing the tendon-splitting approach and the lateral approach would have comparably effective relief of pain for both types of calcaneal ostectomies. We retrospectively reviewed 30 patients (31 feet) who underwent the tendon-splitting approach and compared their results with 32 previous patients (35 feet) who had a lateral incision. Minimum followup was 12 months (mean, 16 months; range, 12–23 months) for the tendon-splitting group and 15 months (mean, 51 months; range, 15–109 months) for the lateral group. The mean American Orthopaedic Foot and Ankle Society score improved from 43 points preoperatively to 81 points (range, 8–100 points) postoperatively in the tendon-splitting group and from 54 points to 86 points (range, 55–100 points) in the lateral group. The mean physical component score of the Short Form-36, version 2, at followup was 52 (range, 22–61) in the tendon-splitting group and 49 (range, 34–63) in the lateral group. The median return to normal function was 4.1 months (range, 3–13 months) in the tendon-splitting group and 6.4 months (range, 4–20 months) in the lateral group. Both approaches to calcaneal ostectomy provided symptomatic pain relief. However, patients in the tendon-splitting group returned to normal function quicker than patients in the lateral group.>Level of Evidence: Level III, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidence.
机译:对于难治性跟骨后滑囊炎(Haglund综合征)的患者,尚未确定最有效的手术方法。我们询问接受肌腱劈开法和外侧法的患者对于两种跟骨造口术是否都可以相对有效地缓解疼痛。我们回顾性分析了30例行腱切断术的患者(31英尺),并将其结果与32例先前有侧切口的患者(35英尺)进行了比较。肌腱劈裂组的最小随访时间为12个月(平均16个月;范围12–23个月),外侧组最小随访15个月(平均51个月;范围15–109个月)。美国骨科足踝学会的平均评分从肌腱劈裂组的术前评分从术前的43分提高到术后的81分(范围:8–100分),从外侧分从54分提高到86分(范围:55–100分)组。随访时,Short Form-36,版本2的平均物理成分评分在腱分裂组中为52(范围22-61),在外侧组中为49(范围34-63)。肌腱劈裂组中位恢复正常功能的中位数为4.1个月(范围3-13个月),外侧组为6.4个月(范围4-20个月)。两种方法行跟骨骨种植术均可以缓解症状。但是,肌腱分裂组的患者比外侧组的患者恢复正常功能的速度更快。>证据水平: III级,回顾性比较研究。有关证据水平的完整说明,请参见《作者指南》。

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