摘要
[目的]探讨泰勒支架在踝关节周围畸形矫正中的应用疗效。[方法]2014年7月～2017年7月共治疗踝关节周围畸形10例,术前常规拍标准踝关节正位X线片,根据影像学资料全面评估踝关节短缩、成角、旋转、移位情况,设计截骨平面。术中根据截骨平面按照穿针要求两侧安装固定泰勒环,近端标准环垂直骨平面,依据所定位截骨平面进行截骨操作,确认截断后,连接固定连接杆并将6根连接杆序码按照要求安装。术后1周复查,拍摄标准的正侧位X线片以及大体照片,于X线片上测量踝关节的畸形参数,并用电脑输入畸形参数来模拟矫正结果并获得畸形的矫正参数。然后依据新生成的矫正处方调整6个连接杆,调整结束后,再次拍摄标准正侧位X线片、外观照片。根据处方提示,必要时更换需要调整的连接杆直至畸形矫正,截骨处愈合,功能良好,逐步拆除外固定架。[结果]所有患者均获得随访,随访时间3～12个月,所有患者踝关节功能恢复良好,畸形得到纠正。[结论]泰勒支架在矫正畸形的同时可进一步调整踝关节的活动度,使之接近正常生理解剖,术后恢复功能、外观良好,为治疗踝关节周围畸形提供了一种新的方法。
[Objective] To explore the outcomes of Taylor Spatial Frame （TSF） using for deformity correction around the ankle. [Method] From June 2014 to June 2017, 10 patients with various deformities around the ankle underwent surgically correction with the TSF. Before operation, the X films of standard anteroposterior and lateral ankle were taken from all the patients. The plane of osteotomy was designed after a comprehensive assessment conducted, including limb shortening, angulation, rotation and displacement. In operation, the pins were inserted referring to the plane of osteotomy to meet the requirements of proximal and distal Taylor rings, which in the standard plane should be perpendicular to the bone. After the osteotomy finished at the predetermined plane was confirmed, the frame was constructed with firm connection of the pins, rings and struts, including the 6 connecting rods installed in the order of serial numbers. The frame was adjusted according to anteroposterior and lateral X films. At one week after operation, X-ray recheck was taken to measure the malformed parameters of ankle on the X film, which was input into the computer. Based the prescription generated by the computer, the frame was continuously regulate by the 6 connecting rods to correct the deformities gradually. The connecting rods should be replaced as they could not meet the requirements of correction. Finally the external fixation can be gradually removed after the bone healed combined with the good function. [Results] All the patients were followed up for 3 to 12 months. All of them got good functional recovery with satisfactory deformity correction. [Conclusion] TSF does correct the deformities and concurrently adjust the ankle range of motion more close to the normal physiological anatomy, provide a new approach to correct the malformed ankle.
作者
刘红顺
周细作
康庆林
LIU Hong-shun;ZHOU Xi-zuo;KANG Qing-lin(The First Department of Lower Extremity, Zhengzhou Orthopaedic Hospital, Zhengzhou 450052, China;Department of Lower Extremity, Wenling Bone Injury Hospital, Taizhou 317500, China;Department of Extremity Repairing and Reconstruction, The Sixth People＇ s Hospital of Shanghai City, Shanghai 200120, China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2018年第7期663-666,共4页
Orthopedic Journal of China
关键词
踝关节周围畸形
泰勒支架
矫正
疗效
ankle malformation, Taylor spatial frame, correction, healing, outcome
