摘要目的:观察撕脱骨块摘除缝合桥技术重建跟腱止点治疗Beavis Ⅲ型跟骨结节撕脱骨折的效果。方法:采用回顾性研究，以2013年1月至2023年1月唐山市第二医院足踝外一科、足踝外二科手术治疗的Beavis Ⅲ型跟骨结节撕脱骨折患者为研究对象，根据治疗方式不同，选择其中采取撕脱骨块摘除缝合桥技术重建跟腱止点治疗的41例患者为观察组；采取跟骨结节撕脱骨折切开复位内固定治疗的37例患者为对照组。比较两组患者的切口迟延愈合率、术后1年Haglund畸形发生率、Maryland足功能评定优良率、美国足踝骨科协会（American Orthopedic Foot and ankle Society，AOFAS）踝-后足评分、疼痛评分、跟腱评分及按Arner-Lindholm疗效评定标准评价优良率。正态或近似正态分布的计量资料组间比较采用独立样本 t检验，计数资料组间比较采用 χ2检验。 结果:术后1年，观察组患者发生Haglund畸形发生率为4.88%（2/41），低于对照组的29.73%（11/37），两组比较差异有统计学意义（ χ2=8.65， P=0.003）；观察组患者的Maryland足功能评定优良率为85.37%（35/41）高于对照组56.76%（21/37），两组比较差异有统计学意义（ χ2=7.86， P=0.005）；观察组AOFAS踝-后足评分［（90.44±6.66）分］高于对照组［（82.84±7.43）分］，两组比较差异有统计学意义（ t=4.77， P<0.001）；观察组疼痛评分［（1.51±1.05）分］低于对照组［（2.95±1.13）分］，两组比较差异有统计学意义（ t=-5.81， P<0.001）；观察组跟腱评分［（81.05±5.87）分］高于对照组［（71.62±8.60）分］，两组比较差异有统计学意义（ t=5.70， P<0.001）；观察组患者的跟腱Arner-Lindholm疗效评价优良率87.80%（36/41）高于对照组67.57%（25/37），组间比较差异有统计学意（ χ2=4.67， P=0.031）。 结论:采取撕脱骨块摘除的方式治疗Beavis Ⅲ型跟骨结节撕脱骨折可在摘除撕脱骨块的同时截除增生的骨赘、硬化骨质及跟骨Haglund畸形，清理变性的跟腱、止点周围炎性组织；采取缝合桥技术重建跟腱止点具有固定强度大，允许早期功能练习，避免内固定物二次取出等优势，取得满意疗效，值得临床推广。

abstractsObjective:To observe the effect of reconstruction of Achilles insertion with Suture bridge technology after extirpation of avulsed bones block in the treatment of Beavis type Ⅲ avulsion fracture of the calcaneal tuberosity.Methods:The retrospective analysis was used. From January 2013 to January 2023, 78 patients with Beavis type Ⅲ avulsion fracture of the calcaneal tuberosity, treated in the Department 1 of Foot and Ankle and Department 2 of Foot and Ankle of the second Hospital of Tangshan were selected as research objects. According to different operation performed, 41 patients with the reconstruction of Achilles insertion with Suture bridge technology after extirpation of avulsed bones block were divided into the observation group and 37 patients with the open reduction internal fixation (ORIF) were divided into the control group. The delayed wound healing rate and the Haglund malformation rate, Maryland foot score, the American Orthopedic Foot and ankle Society (AOFAS) ankle-hindfoot score, the pain Visual Analogue Scale/Score (VAS) score, the Victorian Institute of Sports Assessment-Achilles (VISA-A) score, Arner-Lindholm scale of One-year postoperative were compared between these two groups. The measurement data with normal or approximate normal distribution were analyzed using t test, count data using chi-square test for comparison of between groups.Results:One year after surgery, the incidence of Haglund malformation in the observation group was 4.88% (2/41), which was lower than the control group's 29.73% (11/37). The difference between the two groups was statistically significant ( χ2=8.65,P=0.003). The excellent and good rate of Maryland foot function assessment in the observation group was 85.37% (35/41) higher than that in the control group (56.76% (21/37), and the difference between the two groups was statistically significant ( χ2=7.86, P=0.005). The AOFAS ankle hind foot score of the observation group ((90.44±6.66) points) was higher than that of the control group ((82.84±7.43) points), and the difference between the two groups was statistically significant ( t=4.77, P<0.001). The pain score of the observation group ((1.51±1.05) points) was lower than that of the control group ((2.95±1.13) points), and the difference between the two groups was statistically significant ( t=-5.81, P<0.001). The Achilles tendon score of the observation group ((81.05±5.87) points) was higher than that of the control group ((71.62±8.60) points), and the difference between the two groups was statistically significant ( t=5.70, P<0.001). The excellent and good rate of Arner Lindholm treatment efficacy evaluation for Achilles tendon in the observation group was 87.80% (36/41), which was higher than that in the control group (67.57% (25/37)), and the difference between the groups was statistically significant. Conclusion:The treatment of Beavis Ⅲ type calcaneal nodule avulsion fracture by removing the bone fragment can simultaneously remove the hypertrophic osteophyte, hardened bone, and Haglund deformity of the calcaneus, and clean the degenerated Achilles tendon and inflammatory tissue around the insertion point; The use of suture bridge technology to reconstruct the Achilles tendon insertion point has the advantages of high fixed strength, allowing early functional exercise, avoiding secondary removal of internal fixation, and achieving satisfactory therapeutic effects, which is worthy of clinical promotion.