三关节融合术的临床研究进展  

Clinical research progress of triple arthrodesis

作　　者：屈福锋 梁晓军 李毅 蔡杰 Qu Fufeng;Liang Xiaojun;Li Yi;Cai Jie(Department of Graduate School Xi'an Medical University,Xi'an 710068,China)

机构地区：[1]西安医学院研究生处,710068 [2]西安市红会医院足踝外科诊疗中心

出　　处：《中华解剖与临床杂志》2018年第5期450-454,共5页Chinese Journal of Anatomy and Clinics

基　　金：陕西省自然科学基金(2104JM2-8175);陕西省科技厅社发公关项目(2014K11-05-02)

摘　　要：目的 总结三关节融合术的研究进展,为临床更好地开展三关节融合术提供理论依据.方法 以"三关节融合术"和"triple arthrodesis"为关键词分别在万方数据库和PubMed数据库检索1998年1月—2018年2月关于三关节融合术的文献并对其进行归纳分析.结果 三关节融术的临床疗效是肯定的,但手术并发症难以避免.双切口是三关节融合术的主流选择,但是单独内侧切口及单独外侧入路在特定条件下也有使用.三关节融合的固定方式多种多样,具体应用时应根据实际情况决定.关节镜下的三关节融合术目前应用并不广泛,但是作为一种相对前沿的技术有着广阔的临床应用前景.保留跟骰关节的三关节融合符合现在足踝外科保关节的理念,至于是否值得临床推广还需进一步研究.植骨在三关节融合中通常是必须的,在临床工作中应该视具体情况而定.结论三关节融合术是临床广泛应用的一种手术方式,其临床疗效确切,在实际应用中采取何种入路及切口、何种固定方式、能否采用关节镜、是否保留跟骰关节、是否植骨要视具体情况而定.Objective To summarize the clinical research progress of triple arthrodesis procedures to provide a theoretical basis for the better clinical implementation of the procedures.Methods Databases including PubMed and WanFang Data were electronically searched with "三关节融合术"in Chinese and "triple arthrodesis"in English as the key words to collect the relevant studies from January 1998 to February 2018.Results The clinical outcomes of triple arthrodesis were satisfactory,but complications were inevitable.The double incision was the main choice for the triple arthrodesis at present,but the single internal incision and the single lateral approach were also used in certain condition.In addition,there were a variety of fixed methods for the triple arthrodesis that should be decided according to the actual situation for its application.Arthroscopic triple arthrodesis has not widely been used in the clinical practice,but it has a broad prospect in clinical application as a relatively advanced technology.Triple arthrodesis with calcaneocuboid joint met the preserving joint concept of current ankle surgery,but it was necessary to further study whether it was worthy of clinical application.Bone grafting was usually necessary in triple arthrodesis, but it should depend on the clinical practice.Conclusions Triple arthrodesis is a surgical procedure, which has been widely used in the clinical practice,and its clinical efficacy is definitely satisfactory.In the actual application,what approach and incision,what kind of fixation,whether arthroscopy can be used, whether to retain the calcaneocuboid joint,and whether to use the bone graft or not will depend on the specific circumstances.

关 键 词：关节融合术 手术切口 固定方式 植骨 跟骰关节 

分 类 号：R687[医药卫生—骨科学]