目的 比较两种骨性腓骨沟加深技术——皮质下钻孔打压成形术与骨瓣翻转开窗术，治疗慢性腓骨肌腱滑脱（CPTS）的中期临床疗效及对足底压力分布的影响，为临床术式选择提供生物力学依据。 方法 采用回顾性队列研究设计，纳入2022年1月至2024年12月于南昌市洪都中医院接受手术治疗的52例CPTS患者。根据手术方式分为改良组（皮质下钻孔打压成形术联合腓骨上支持带重建，n = 26）和常规组（骨瓣翻转开窗术联合腓骨上支持带重建，n = 26）。术后平均随访18.4个月。比较两组患者术后12个月的美国足踝外科协会（AOFAS）踝-后足评分、疼痛视觉模拟评分（VAS），并采用Sennoscan120足底压力测力板系统分析步态周期中双足各区域的峰值压力（PP）、压力-时间积分（PTI）及对称性指数（SI）。 结果 术后12个月，两组AOFAS与VAS评分均较术前显著改善（P < 0.05），但组间差异无统计学意义（P > 0.05）。足底压力分析显示，改良组在步态推进期患侧第4、5跖骨区的峰值压力对称性指数（SI-PP）显著优于常规组（P < 0.05）。常规组患侧后足区域的SI-PTI显著高于改良组（P < 0.05），提示其存在后足负荷时间延长及外侧柱推力不足的代偿性步态。改良组压力中心（CoP）的冠状面摆动幅度更接近健侧。 结论 两种术式在缓解疼痛和改善踝关节功能方面疗效相当。但皮质下钻孔打压成形术能更有效地恢复足外侧柱在步态推进期的负荷特征，减少代偿性步态，在促进自然步态恢复方面具有生物力学优势。

Objective To compare the mid-term clinical efficacy and the impact on foot pressure distribution of two techniques for deepening the bony fibular groove-sub-cortical drilling and pressurization technique and bone flap flipping and window opening technique-in the treatment of chronic fibular tendon dissociation （CPTS）， and to provide a biomechanical basis for clinical surgical selection. Methods A retrospective cohort study design was employed. A total of 52 patients with CPTS who underwent surgical treatment at Hongdu Central Hospital in Nanchang City between January 2022 and December 2024 were included in the study. Based on the surgical methods， the patients were divided into the modified group （sub-cortical drilling and pressurization technique combined with fibular upper support band reconstruction， n = 26） and the conventional group （bone flap flipping and window opening technique combined with fibular upper support band reconstruction， n = 26）. The average postoperative follow-up period was 18.4 months. The American Orthopedic Foot and Ankle Society （AOFAS） ankle-hindfoot scores and pain visual analogue scale （VAS） scores of the two groups at 12 months after surgery were compared. Additionally， the peak pressure （PP）， pressure-time integral （PTI）， and symmetry index （SI） of each area of both feet during the gait cycle were analyzed using the Sennoscan 120 foot pressure force plate system. Results Twelve months after surgery， the AOFAS and VAS scores of both groups were significantly improved compared with those before surgery （P < 0.05）. However， there was no statistically significant difference between the groups （P > 0.05）. Foot pressure analysis indicated that， during the gait progression phase， the SI-PP of the affected side in the fourth and fifth metatarsal regions of the modified group was significantly better than that of the conventional group （P < 0.05）. The SI-PTI of the affected side in the hindfoot region of the conventional group was significantly higher than that of the modified group （P < 0.05）， which suggests the presence of compensatory gait with prolonged load time on the hindfoot and insufficient external column thrust. The coronal plane swing amplitude of the pressure center （CoP） of the modified group was closer to that of the healthy side. Conclusions The two surgical methods exhibit comparable efficacy in relieving pain and enhancing ankle joint function. Nevertheless， the sub-cortical drilling and pressurization technique can more effectively restore the load characteristics of the lateral column of the foot during the gait progression phase and mitigate compensatory gait， thereby presenting biomechanical advantages in facilitating the recovery of natural gait.