Liang Zhenyang,Deng Huicheng,Wang Weicai,et al.Preliminary report on the effect of suture anchor in fixation of tibialis anterior tendon split and transfer in children with cerebral palsy and clubfoot[J].Journal of Clinical Pediatric Surgery,2024,(07):677-681.[doi:10.3760/cma.j.cn101785-202405068-013]
带线锚钉用于儿童脑瘫性马蹄内翻足胫前肌腱劈开移位固定的效果分析
- Title:
- Preliminary report on the effect of suture anchor in fixation of tibialis anterior tendon split and transfer in children with cerebral palsy and clubfoot
- Keywords:
- Cerebral Palsy; Clubfoot Deformity; Tibialis Anterior Tendon; Surgical Procedures; Operative; Child
- 摘要:
- 目的 初步探讨带线锚钉用于儿童脑瘫性马蹄内翻足胫前肌腱劈开移位(split anterior tibialis tendon transfer,SPLATT)的临床疗效。方法 回顾性分析2018年6月至2021年1月娄底市第一人民医院儿童骨科18例接受SPLATT并应用带线锚钉固定肌腱方法治疗的儿童脑瘫性马蹄内翻足患儿资料。男12例、女6例;单侧13例、双侧5例。观察18例患儿术前、术后粗大运动功能分级(gross motor function classification system,GFMCS)、胫前肌肌力,采用Kling评价标准评定矫形结果和行走功能。结果 18例均获得完整随访,手术时年龄(12.5±5.2)岁,术后随访(26.3±5.4)个月。术后早期无一例发生肌腱脱出、肌腱弓状突起和切口感染等并发症。按医学研究委员会肌力分级标准判定胫前肌肌力:术前5级15例、4级3例,术后5级15例、4级3例;差异无统计学意义(P>0.05);GFMCS分级:术前Ⅰ级8例、Ⅱ级7例、Ⅲ级3例,术后Ⅰ级10例、Ⅱ级7例、Ⅲ级1例;差异无统计学意义(P>0.05);末次随访时,依照Kling 评价标准评价足部功能:优15例,良3例。结论 带线锚钉固定胫前肌腱可获得与传统固定方法相似的固定结果;但带线锚钉固定操作更简便,可减少足底软组织损伤,手术时间更短。
- Abstract:
- Objective To preliminarily explore the clinical efficacy of split anterior tibialis tendon transfer (SPLATT) with suture anchor fixation in the treatment of clubfoot in children with cerebral palsy.Methods A retrospective analysis was conducted on 18 cases of clubfoot in children with cerebral palsy who underwent SPLATT with suture anchor fixation at the Department of Pediatric Orthopedics,Hunan Loudi First People’s Hospital from June 2018 to January 2021.There were 12 males and 6 females;13 unilateral cases and 5 bilateral cases.Preoperative and postoperative gross motor function classification system (GMFCS) and tibialis anterior muscle strength were evaluated.The Kling evaluation criteria were used to assess orthopedic results and walking function.Results All 18 patients had complete follow-up.The average age at the time of surgery was 12.5±5.2 years,and the postoperative follow-up period was 26.3±5.4 months.No early postoperative complications such as tendon extrusion,tendon bowstringing,or incision infection occurred.According to the MRC muscle strength grading for the tibialis anterior muscle:preoperatively,15 cases were grade 5 and 3 cases were grade 4;postoperatively,15 cases were grade 5 and 3 cases were grade 4;the difference was not statistically significant (P>0.05).GFMCS grading:preoperatively,8 cases were grade 1,7 cases were grade 2,and 3 cases were grade 3;postoperatively,10 cases were grade 1,7 cases were grade 2,and 1 case was grade 3;the difference was not statistically significant (P>0.05).At the final follow-up,according to the Kling evaluation criteria for foot function:15 cases were excellent,and 3 cases were good.Conclusions Suture anchor fixation of the tibialis anterior tendon can achieve similar fixation results to traditional fixation methods.However,suture anchor fixation is simpler to perform,reduces soft tissue injury of the foot,and shortens operation time.
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备注/Memo
收稿日期:2024-5-27。
基金项目:湖南省卫健委科研项目(202104071292)
通讯作者:李宇,Email:187040296@qq.com