前路踝关节融合术治疗踝关节严重病损的临床研究  

Clinical research on anterior ankle arthrodesis for serious ankle lesions

作　　者：邱桂斌[1] 周春晖[1] 赵金伟[1] 孙松盛[1] 

机构地区：[1]山东省烟台市莱阳中心医院骨一科265200

出　　处：《中国矫形外科杂志》2010年第17期1416-1418,共3页Orthopedic Journal of China

摘　　要：[目的]观察前路踝关节融合术治疗踝关节严重病损的临床疗效。[方法]1998年7月～2009年6月37例踝关节严重病损的患者行前路踝关节融合,男23例,女14例;年龄22～73岁,平均49.6岁;右足21例,左足16例。其中创伤性关节炎25例,骨性关节炎6例。术中采用前路植骨及重建钢板内固定,术后石膏外固定。随访6个月～4年,采用AOFAS评分从疼痛、行走功能、踝关节对线进行评定,比较术前及末次随访AOFAS评分以判定疗效,X线片评估术后融合情况。[结果]本组病例术后均未发生切口感染、血管神经损伤等并发症。最后随访时,37例中32例无明显不适,3例踝关节轻度疼痛,2例踝关节轻度肿胀,长时间行走或站立后足跟部有轻度酸胀感,并未影响日常生活。AOFAS评分由术前的27.95±17.94提高至术后的86.43±5.83,总分以及疼痛、行走功能、对线各项目的积分均显著提高（P〈0.01）,总分评分优良率为91.89%（34/37）。随访时X线片示所有病例均达到骨性融合。[结论]采用经踝前入路踝关节融合术治疗踝关节严重病损,操作简单、植骨融合率高、并发症少,疗效值得肯定。[Objective]To introduce a modified technique of ankle arthrodesis with reconstruction plate fixation via anterior approach and evaluate clinical effects. [Methods]A retrospective study was carried out in 37 patients,including 23 males and 14 females,age ranged from 22 to 73 years with an average of 49.6 years.All of the patients suffered from serious ankle lesions,including traumatic arthritis in 25 patients and osteoarthritis in 6 patients.They were treated by anterior ankle arthrodesis with reconstruction plate fixation from July 1998 to June 2009.The patients were followed up for from 6 months to 4 years and evaluated with AOFAS score and standard X-ray.[Results]No severe complications,such as incision infection and neurovascular injuries occurred in this group of patients.At the latest follow up,of the 37 patients,32 had no remarkable discomfort,3 had mild pain and 2 had mild swelling around affected ankle after long time standing or walking,which did not interfere daily activity significantly.The average AOFAS score increased from 27.95±17.94 preoperatively to 86.43±5.83 at the final follow-up（P0.01）.The excellent to good rate was 91.89%（34/37）.All of 37 cases had bony fusion and the fusion rate was 100%.[Conclusion]Anterior ankle arthrodesis is a simple operation with high fusion rate and less complications.It is a kind of treatment method with definite curative effect.

关 键 词：踝关节 关节融合术 植骨术 重建钢板 

分 类 号：R687.3[医药卫生—骨科学]