第一跖趾关节Swanson人工假体置换术及其疗效评价  

Swanson double-stem silicone implant arthroplasty of first metatarsophalangeal point

作　　者：金今[1] 李其一[1] 林进[1] 李佳忆[1] 邱贵兴[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院骨科,100730

出　　处：《中华医学杂志》2005年第29期2050-2053,共4页National Medical Journal of China

摘　　要：目的评价Swanson双柄硅胶人工铰链式假体第一跖趾关节置换术的疗效.方法使用Swanson双柄硅胶人工铰链式假体实施第一跖趾关节置换术10例13个关节,其中老年骨关节炎拇外翻8例10足,类风湿关节炎1例2足,创伤性关节炎1例1足.结果全部病例获得随访,随访时间12个月～38个月,平均25个月.8例患者获得了完全满意的效果,1例病人部分满意.不满意的1例患者是因为关节置换术后3年跖趾关节截骨面出现了较严重的骨质增生而引起疼痛的症状.有2例出现硅胶假体周围明显的骨溶解,但无症状,未作特殊处理.结论 Swanson双柄硅胶假体第一跖趾关节置换术能够保留关节活动度及路(足母)趾长度,从而维持前足正常的行走功能,达到消除跖趾关节疼痛、改善功能、矫正畸形等理想的效果,是重建跖趾关节的有效方法.Objective To evaluate the curative effectiveness of Swanson double-stem silicone implant arthroplasty on the reconstruction of first metatarsophalangeal joint. Methods Swanson double-stem silicone implant arthroplasty was performed on 10 patients, 2 males and 8 females, aged 60 （ 57 - 75 ）,suffering from diseases of first metatarsophalangeal joint with 13 diseased joints, including haUux valgus with geriatric osteoarthritis （8 cases, 10 joints）, rheumatoid arthritis （1 case, 2 joints）, and traumatic arthritis （ 1 case, 1 joint）. All patients were followed up for an average of 25 months （ 12 ~ 38 months）. Results Eight patients felt complete satisfaction with the operation, 1 patient showed satisfaction to some extent, and 1 patient was not satisfied because of pain of the first matatarsophalangeal joint due to severe hyperosteogeny surrounding the cut bone face 3 years after the operation. Osteolysis around the silicone implant occurred in 2 cases without clinical symptoms, and no special treatment was given. Conclusion With the advantages of alleviating pain, preserving the length and alignment of great toe, improving the function of walking, and correcting the deformity, Swanson double-stem silicone implant arthroplasty is effective on reconstruction of the first metatarsophalangeal joint.

关 键 词：跖趾关节 足畸形 关节成形术 假体植入 

分 类 号：R687.4[医药卫生—骨科学]