• 同濟大學附屬同濟醫(yī)院骨科（上海，200065）;

目的 探討跟距骨橋的手術治療方法及療效。 方法 2008 年7 月－ 2010 年10 月，手術治療跟距骨
橋患者10 例。男4 例，女6 例；年齡16 ～ 70 歲，平均53.5 歲。先天性骨橋2 例，繼發(fā)性骨橋8 例。跟距中間關節(jié)面骨橋
3 例，后關節(jié)面骨橋7 例。術前患者疼痛視覺模擬評分（VAS）為（9.0 ± 0.4）分；根據美國矯形足踝協(xié)會（AOFAS）后足評
分標準為（42.4 ± 1.4）分。合并距下關節(jié)退變2 例。8 例單純跟距骨橋患者行骨橋切除并脂肪組織植入，2 例合并距下關
節(jié)退變患者行骨橋切除聯合距下關節(jié)融合術。 結果 術后切口均Ⅰ期愈合。8 例獲隨訪，隨訪時間12 ～ 36 個月，平均
18 個月。末次隨訪時VAS 評分為（2.0 ± 0.7）分，與術前比較差異有統(tǒng)計學意義（t=6.425，P=0.000）。AOFAS 后足評分為
（86.9 ± 2.3）分，與術前比較差異有統(tǒng)計學意義（t=7.634，P=0.000）。單純骨橋切除者末次隨訪時X 線片檢查示無骨橋復
發(fā)及關節(jié)退變發(fā)生，關節(jié)融合者X 線片示達骨性融合。 結論 跟距骨橋根據不同發(fā)生部位和合并癥，分別采用單純骨
橋切除或聯合距下關節(jié)融合術可取得較好療效。

引用本文： 俞光榮,李春光,李兵,楊云峰,李海豐,周家鈐,袁鋒. 手術治療跟距骨橋療效觀察. 中國修復重建外科雜志, 2012, 26(5): 522-526. doi: 復制

1. Zaw H, Calder JD. Tarsal coalitions. Foot Ankle Clin, 2010, 15(2): 349-364.
2. Huskisson EC. Measurement of pain. Lancet, 1974, 2(7789): 1127-1131.
3. Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallax, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
4. Root ML. Reappraisal of the negative impression cast and the subtalar joint neutral position revisited. J Am Podiatr Med Assoc, 1997, 87(4): 192-193.
5. Fleming P, Rice JJ, Kelly I, et al. Resection of talocalcaneal coalition—the effect on subtalar joint movements. Foot and Ankle Surgery, 2004, 10(1): 13-16.
6. Harris RI. Rigid valgus foot due to talocalcaneal bridge. J Bone Joint Surg (Am), 1955, 37-A(1): 169-183.
7. Kulik SA Jr, Clanton TO. Tarsal coalition. Foot Ankle Int, 1996, 17(5): 286-296.
8. Blitz NM. Pediatric & adolescent flatfoot reconstruction in combination with middle facet talocalcaneal coalition resection. Clin Podiatr Med Surg, 2010, 27(1): 119-133.
9. Bonasia DE, Phisitkul P, Saltzman CL, et al. Arthroscopic resection of talocalcaneal coalitions. Arthroscopy, 2011, 27(3): 430-435.
10. Field C, Ng A. Resection of middle facet coalition with arthroscopic guidance. J Foot Ankle Surg, 2009, 48(2): 273-276.
11. Albert A, Deleu PA, Leemrijse T, et al. Posterior arthroscopic subtalar arthrodesis: ten cases at one-year follow-up. Orthop Traumatol Surg Res, 2011, 97(4): 401-405.
12. Schenkel D, Degraauw J, Degraauw C. Talocalcaneal coalition in a 15 year old female basketball player. J Can Chiropr Assoc, 2010, 54(4): 222-228.
13. Sperl M, Saraph V, Zwick EB, et al. Preliminary report: resection and interposition of a deepithelialized skin flap graft in tarsal coalition in children. J Pediatr Orthop B, 2010, 19(2): 171-176.
14. Di Liddo PE, Rivard DS, Mehler AS, et al. Resection of talocalcaneal middle facet coalition. Interposition with a tensor fascia lata allograft: a case report. J Foot Ankle Surg, 2000, 39(5): 336-340.
15. El Shazly O, Abou El Ela AA. Percutaneous resection of calcaneo-navicular coalition with interposition of synthetic graft. Foot (Edinb), 2011, 21(3): 138-141.
  1. 1. Zaw H, Calder JD. Tarsal coalitions. Foot Ankle Clin, 2010, 15(2): 349-364.
  2. 2. Huskisson EC. Measurement of pain. Lancet, 1974, 2(7789): 1127-1131.
  3. 3. Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallax, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
  4. 4. Root ML. Reappraisal of the negative impression cast and the subtalar joint neutral position revisited. J Am Podiatr Med Assoc, 1997, 87(4): 192-193.
  5. 5. Fleming P, Rice JJ, Kelly I, et al. Resection of talocalcaneal coalition—the effect on subtalar joint movements. Foot and Ankle Surgery, 2004, 10(1): 13-16.
  6. 6. Harris RI. Rigid valgus foot due to talocalcaneal bridge. J Bone Joint Surg (Am), 1955, 37-A(1): 169-183.
  7. 7. Kulik SA Jr, Clanton TO. Tarsal coalition. Foot Ankle Int, 1996, 17(5): 286-296.
  8. 8. Blitz NM. Pediatric & adolescent flatfoot reconstruction in combination with middle facet talocalcaneal coalition resection. Clin Podiatr Med Surg, 2010, 27(1): 119-133.
  9. 9. Bonasia DE, Phisitkul P, Saltzman CL, et al. Arthroscopic resection of talocalcaneal coalitions. Arthroscopy, 2011, 27(3): 430-435.
  10. 10. Field C, Ng A. Resection of middle facet coalition with arthroscopic guidance. J Foot Ankle Surg, 2009, 48(2): 273-276.
  11. 11. Albert A, Deleu PA, Leemrijse T, et al. Posterior arthroscopic subtalar arthrodesis: ten cases at one-year follow-up. Orthop Traumatol Surg Res, 2011, 97(4): 401-405.
  12. 12. Schenkel D, Degraauw J, Degraauw C. Talocalcaneal coalition in a 15 year old female basketball player. J Can Chiropr Assoc, 2010, 54(4): 222-228.
  13. 13. Sperl M, Saraph V, Zwick EB, et al. Preliminary report: resection and interposition of a deepithelialized skin flap graft in tarsal coalition in children. J Pediatr Orthop B, 2010, 19(2): 171-176.
  14. 14. Di Liddo PE, Rivard DS, Mehler AS, et al. Resection of talocalcaneal middle facet coalition. Interposition with a tensor fascia lata allograft: a case report. J Foot Ankle Surg, 2000, 39(5): 336-340.
  15. 15. El Shazly O, Abou El Ela AA. Percutaneous resection of calcaneo-navicular coalition with interposition of synthetic graft. Foot (Edinb), 2011, 21(3): 138-141.