Swanson人工跖趾关节置换治疗Freiberg病近期疗效观察  

Swanson double-stem silicone implant arthroplasty in the treatment of Freiberg disease

作　　者：温建民[1] 孙卫东 桑志成[1] 胡海威[1] 孙永生[1] 蒋科卫[1] 梁朝[1] 程桯[1] 林新晓[1] 吴夏勃[1] 

机构地区：[1]中国中医科学院望京医院骨关节科,北京100102

出　　处：《中国骨伤》2009年第6期423-425,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:观察Swanson人工跖趾关节置换治疗晚期Freiberg病近期疗效。方法:2006年7月至2007年12月应用Swanson人工关节假体实施跖趾关节置换手术治疗晚期Freiberg病13例(18足),其中男1例(1足),女12例(17足)。合并母外翻12例(17足),创伤性关节炎1例(1足)。病变均为第2跖趾关节。X线参照Smillie分期,所有患足均为晚期,其中4期11足,5期7足。采用美国足踝外科协会AOFAS评分系统对手术前后疼痛、行走、穿鞋及跖趾关节活动度等进行临床评价。随访时间3～17个月,平均11.3个月。结果:所有病例术后关节疼痛明显改善,活动度改善。术前AOFAS评分平均为(50.06±9.59)分,术后平均为(77.50±4.99)分,术后与术前AOFAS评分相比,差异有统计学意义(P<0.05)。结论:Swanson人工跖趾关节置换术治疗晚期Freiberg病近期疗效满意,能明显改善关节活动度及疼痛,是一种较为可行的术式。Objective ： To observe the short-term results of Swanson double-stem silicone implant arthroplasty in the treatment of late stage Freiberg disease. Methods：From July 2006 to December 2007,Swanson double-stem silicone implant arthroplasty was performed on 13 patients, 1 male （1 foot） and 12 females （17 feet）, suffering from late stage Freiberg diseases. All the cases were the second metatarsophalangeal joints. According to the Smillie classification, 11 feet present with grade 4 osteonecrosis ,7 feet with grade 5. The AOFAS scoring system was used for clinical assessment. All the patients were followed up for an average of 11.3 months （3 to 17 months）. Results：The mean preoperative and postoperative AOFAS scores were （50.06±9.59） and （77.50±4.99）, respectively （P〈0.05）. The complaint of pain with joint motion was decreased in all patients. The postoperative passive range of motion of joints improved significantly. Conclusion：Swanson double-stem silicone implant arthroplasty yields satisfied short-term results in late stage Freiberg disease ,which is effective to improve range of motion and relieve pain of joint.

关 键 词：跖趾关节 关节成形术 置换 假体置入 跖骨 

分 类 号：R682.160.4[医药卫生—骨科学] R-02[医药卫生—外科学]