摘要
目的探讨前路双钢板行踝关节融合术的近期疗效。方法自2009年9月至2011年10月采用前路双钢板行踝关节融合术治疗踝关节严重病损患者15例，男10例，女5例；年龄22～59岁，平均39．2岁。创伤性关节炎9例，骨关节炎3例，类风湿性关节炎3例。通过比较术前与末次随访时美国足踝外科协会（AOFAS）踝。后足评分评定疗效，术后根据踝关节X线检查观察融合情况。结果所有患者术后获9～18个月（平均13个月）随访。末次随访时全部踝关节均已骨性融合，融合时问9～28周，平均14周。AOFAS踝一后足评分由术前（36．1±8．1）分提高至末次随访时（82．7±6．3）分，差异有统计学意义（t=23．961，P=0．000）。所有患者切口均Ⅰ期愈合，无感染、局部皮肤坏死等并发症发生。至末次随访末出现螺钉、钢板松动、断裂等现象。结论利用踝关节前路双锁定钢板行踝关节融合术适用于病变严重、骨质缺损较多的患者，短期疗效确切。
Objective To report short-term outcomes of ankle arthrodesis using anterior double plating system. Methods From September 2009 to October 2011, 15 patients with end-stage arthritis of the ankle were treated by ankle arthrodesis with anterior double plating system in our department. They were 10 males and 5 females, aged from 22 to 59 years （average, 39.2 years） . Nine cases were post-traumatic arthritis, 3 osteoarthritis and 3 rheumatoid arthritis. The ankle function was assessed preoperation and at the last follow-up in all patients according to the ankle and hindfoot scoring of American Orthopaedie Foot and Ankle Society （AOFAS）; bone union was assessed by radiographs. Results The follow-up periods for the 15 patients lasted from 9 to 18 months （average, 13 months） . Bone union was obtained in all at the last follow-up. The fusion time ranged fi＇om 9 to 28 weeks （average, 14 weeks）. The mean AOFAS score increased significantly from preoperative 36. 1 ± 8. 1 points to 82.7 ± 6. 3 points at the last follow-up （ t = 23. 961, P = 0. 000）. All the 15 patients achieved primary healing of incision and were free of complications like infection or local skin necrosis. No implant failure was observed at the last follow-up. Conclusions The anterior double plating system is an effective method to achieve solid ankle arthrodesis, with advantages of clear operative field, simplicity, rigid fixation and high fusion rate. Its short-term efficacy is definite particularly in patients with severe bone defect or loss of bone stock.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2013年第6期490-494,共5页
Chinese Journal of Orthopaedic Trauma
关键词
踝关节
骨关节炎
关节融合术
骨板
Ankle joint
Osteoarthritis
Arthrodesis
Bone plates
