手术治疗慢性跟腱囊炎8例分析

目的探讨慢性跟腱囊炎的手术治疗效果。方法我们对2008年2月至2011年2月收治的8例（9足）慢性跟腱囊炎病例进行回顾性分析，男3例（3足），女5例（6足），年龄32～51岁，平均50．4岁。手术方法采用跟腱外侧人路，剥离跟腱止点将跟腱向上掀起，清除跟骨后上炎性滑囊组织及侵蚀破坏的骨组织，用摆锯去除跟骨后上增生骨嵴并修理平整，如跟腱内有钙化及变性组织一并切除，用带线锚钉将跟腱缝合于止点上。术后踝关节跖屈位短腿石膏固定6～8周，定期随访。结果8例患者随访10～21个月，平均随访12个月。切口均一期愈合，无感染。功能采用美国足踝协会踝与后足功能评分（Americanorthopaedicfootandanklesocietyscore，AOFAS），从术前平均54分提高到术后92分，恢复到正常功能时间为3～6个月，平均4个月。结论跟腱完全剥离、清除炎性滑囊及骨性突出是治疗慢性跟腱囊炎较好的方法，可有效缓解疼痛，改善功能。

Surgical Treatment of Chronic Retrocalcaneal Bursitis:An analysis of 8 Cases

Objective To investigate the effect of surgical treatment of chronic retrocalcaneal bursitis. Methods In this retrospective study,from February 2008 to February 2011,8 patients （9 heels） with retrocalcaneal bursitis were treated surgically. There were 3 male （3 heels） and 5 female （6 heels） with mean age of 50.4years（from 32years to 61 years）. The surgical treatment of chronic retrocalcaneal bursitis by means of complete detachment and reattachment of the Achilles tendon,removal of the retrocalcaneal exostosis,and excision of the retroealeaneal bursa through a lateral approach. Postoperative use of a non-weight-bearig below-the-kneel cast for up 6-8 weeks with foot positioned at a plantarflexion. Patients were identified via chart review. Results The mean duration of postoperative follow-up was 12 months（10 months to 2I months）. There were no wound complications or postoperative infections. The average time to return to normal daily function was 4 months. The American Orthopaedic Foot and Ankle Society score （AO- FAS） were 54befor operation and 92 after operation. Conclusion Complete detachment and reattaehment of the Achilles tendon,removal of the retroealcaneal exostosis,and excision of the retrocalcaneal bursa are effective treat- ment for the retrocalcaneal bursitis.