目的 总结小切口改良螺丝钉内固定在踝关节融合术中的应用效果。
方法 2008年7月-2012年1月,收治22例踝关节终末期病变患者,采用小切口改良螺丝钉内固定行踝关节融合术。男12例,女10例;年龄45~67岁,平均55.4岁。创伤性关节炎8例;腓总神经损伤晚期足下垂,行肌腱转移术效果不佳3例;骨关节炎严重退变4例;类风湿性关节炎2例;踝关节细菌性关节炎静止1年以上2例;距骨坏死2例;Charcot关节病1例。病程36~75个月,平均52个月。
结果 术后切口均Ⅰ期愈合。22例均获随访,随访时间13~18个月,平均15.2个月。X线片示患者均获骨性融合,20例融合时间10~22周,平均14.3周;2例延迟融合,术后12个月获骨性融合。术后13个月美国矫形足踝协会(AOFAS)踝关节功能评分为(71.2±7.3)分,较术前(40.9±9.1)分显著改善(t=-2.974,P=0.000)。
结论 小切口改良螺丝钉内固定具有创伤小、固定牢固、适应证广、融合率高、并发症少等优点,是一种较好的踝关节融合术式。
Citation:
刘威, 赵印震, 王红超. 小切口改良螺丝钉内固定在踝关节融合术中的应用. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(12): 1569-1570. doi: 10.7507/1002-1892.20140340
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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Katsenis D, Bhave A, Paley D, et al. Treatment of malunion and nonunion at the site of an ankle fusion with the Ilizarov apparatus. J Bone Joint Surg (Am), 2005, 87(2):302-309.
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- 1. 杨坤芳, 俞光荣. 踝关节融合术的治疗进展. 中国矫形外科杂志, 2008, 16(24):1871-1873.
- 2. Gougoulias NE, Agathangelidis FG, Parsons SW. Arthroscopic ankle arthrodesis. Foot Ankle Int, 2007, 28(6):695-706.
- 3. Ferkel RD, Hewitt M. Long-term results of arthroscopic ankle arthrodesis. Foot Ankle Int, 2005, 26(4):275-280.
- 4. Katsenis D, Bhave A, Paley D, et al. Treatment of malunion and nonunion at the site of an ankle fusion with the Ilizarov apparatus. J Bone Joint Surg (Am), 2005, 87(2):302-309.