单纯Ilizarov技术与结合软组织松解治疗创伤后重度足下垂畸形的疗效比较  

llizarov technique combined with or without soft tissue release for treatment of rigid equinus con- tracture secondary to trauma

作　　者：孙磊[1] 田敏[1] 胡宏伟[1] 宁廷民[1] 侯存强[1] 刘欣欣[1] 

机构地区：[1]解放军第八十八医院全军骨科中心,山东省泰安市271000

出　　处：《中华创伤骨科杂志》2013年第10期849-853,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的比较单纯Ilizarov技术与结合软组织松解治疗创伤后重度足下垂畸形的疗效。方法2006年10月至2011年12月收治26例创伤后继发性重度足下垂畸形患者，男15例，女11例；年龄14—53岁，平均33．0岁；左侧14例，右侧12例。12例患者采用单纯限制型Ilizarov外固定支架缓慢牵伸矫正（单纯组），14例患者采用软组织松解结合限制型外固定支架缓慢牵伸矫正（结合组）。比较末次随访时两组患者的最大背伸位跖屈角、关节活动度、视觉模拟踝足评分量表（VAS．FA）评分和矫正丢失度等。结果26例患者术后获12—36个月（平均24．8个月）随访。单纯组与结合组患者平均最大背伸位跖屈角由术前的51．7°±6．2°、55．0°±7.3°分别矫正至末次随访时的-9．20±8．7°、-11．40±8．7°，平均关节活动度由术前的7．1°±5．4°、6．4°±5．0°分别增加至末次随访时的25.8°±12．4°、26.4°±10．1°，平均VAS．FA评分由术前的（34．9±5．2）、（33．9±5．5）分增加至末次随访时的（86．6±6．3）、（88．8±4．0）分，同一组组内术前与末次随访时比较差异均有统计学意义（P〈0．05）,而同一时间点两组间比较差异均无统计学意义（P〉0．05）。两组患者的矫正丢失角度比较差异无统计学意义（P〉0．05）。单纯组患者平均矫正时间和带架时间长于结合组，差异均有统计学意义（P〈0．05）。结论单纯Ilizarov技术或软组织松解结合Ilizarov技术均可安全、有效地矫正创伤后重度足下垂畸形，但软组织松解结合Ilizarov技术可显著缩短治疗周期。Objective To compare clinical outcomes of simple Ilizarov technique versus Uizarov technique combined with soft tissue release in the treatment of posttraumatic equinus contracture. Methods From October 2006 to December 2011, 26 patients who had suffered from unilateral rigid equinus con- tracture secondary to trauma were surgically treated in our department. They were 15 males and 11 females, aged 14 to 53 years （average, 33.0 years） . Of them, 12 patients were treated by gradual distraction using simple I]izarov technique （group A） while 14 patients were cured by Ilizarov technique combined with soft tissue release （group B） . The 2 groups were compared in terms of plantar flexion at the maximal dorsiflexion, range of motion （BOM）, Visual Analogue Scale Foot and Ankle （VAS-FA） score and correction loss at the last follow-ups. Results All the 26 patients were followed up from 12 to 36 months （average, 24. 8 months）. The plantar flexion at the maximal dorsiflexion was respectively corrected from 51.7°± 6.2° in group A and 55.0° ± 7. 3° in group B before operation to - 9, 2° ± 8.7° in group A and - 11.4° ± 8.7° in group B at the latest follow up; ROM increased from 7. 1°± 5.4° in group A and 6.4°± 5. 0° in group B preoperatively to 25. 8° ± 12, 4° and 26.4° ± 10. 1° respectively at the latest follow up; VAS-FA was improved from 34. 9 ± 5. 2 points in group A and 33. 9± 5. 5 points in group B preoperatively to 86. 6 ± 6. 3 points and 88. 8 ±4. 0 points respectively at the last follow-up. There were significant differences between preeoration and the last fol- low-up within the same group （ P 〈 0. 05）, but no significant differences between groups at the same time point （ P 〉 0. 05） . Similarly, the correction loss loss not significantly different between the 2 groups（ P 〉 0.05 ）. The frame correction time and the total frame time in group A were significantly longer than those in group B （ P 〈0. 05）. Conclusions Ilizarov technique is very

关 键 词：踝关节 畸形足 伊利扎罗夫技术 软组织损伤 

分 类 号：R687.3[医药卫生—骨科学]