摘要
目的探讨踝上截骨术治疗Takakura 3B期踝关节炎的临床疗效。方法回顾性分析了西安市红会医院足踝外科于2015年1月至2019年6月收治的28例Takakura 3B期内翻型踝关节炎患者,所有患者均采用踝上截骨术治疗,比较患者术前、术后的临床症状及影像学结果,并进行统计学分析。结果术后胫骨远端关节面角(tibial articular surface,TAS)、胫骨侧位远端关节面角(tibial lateral surface,TLS)、距骨倾斜角(talar tilt,TT)和胫骨踝穴角(tibiocrural,TC)及后足力线角(hindfoot alignment,HFA),均较术前显著改善(P<0.05)。美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝与后足功能评分、视觉模拟评分法(visual analogue score,VAS)评分和12项简式健康调查(12-item short-form survey,SF-12)量表评分,均较术前显著改善(P<0.001)。有21例患者获得影像学分期改善,8例患者因感染、骨不连、退变而进行了二次手术。结论踝上截骨术联合辅助手术能有效缓解疼痛,改善踝关节功能及日常生活能力,是治疗Takakura 3B期踝关节炎的有效术式。
Objective To determine the clinical effectiveness of supramalleolar osteotomy in the treatment of Takakura 3B ankle arthritis.Methods Data of 28 patients(28 ankles)with 3B stage ankle arthritis admitted to the department of foot and ankle surgery of Honghui Hospital of Xi’an Jiaotong University from Jan 2015 to Jun 2019 were analyzed retrospectively.All were treated by supramalleolar osteotomy.Preoperative and postoperative clinical and radiographic results were compared and the statistical analysis was performed.Results The tibial articular surface(TAS)angle,tibial lateral surface(TLS)angle,tibiocrural(TC)angle,talar tilt(TT)angle and hindfoot alignment(HFA)angle,showed a significant improvement after surgery(P<0.05).The American Orthopedic Foot and Ankle Society(AOFAS)ankle and hindfoot score,the visual analogue score(VAS)score and the 12-item short-form survey(SF-12)score,showed a significant improvement after surgery(P<0.001).The imaging staging was improved in 21 patients,and 2 operations were performed in 8 patients because of infection,nonunion and degeneration.Conclusion Supramalleolar osteotomy showed improvements in function,pain,and quality of life after surgery and is a reliable surgical method for Takakura 3B stage ankle arthritis.
作者
杨鑫权
张言
王琼
梁景琪
赵宏谋
Yang Xinquan;Zhang Yan;Wang Qiong;Liang Jingqi;Zhao Hongmou(Department of foot and ankle surgery,Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054,China)
出处
《足踝外科电子杂志》
2022年第1期8-12,共5页
Electronic Journal of Foot and Ankle Surgery
基金
陕西省科技厅重点研发项目(2021-SF025)
西安市卫健委青年培育项目(2022qn05)。
