关节镜下距下关节融合术治疗终末期距下关节炎的疗效分析  

Efficiency of arthroscopic subtalar arthrodesis in treatment of terminal subtalar arthritis

作　　者：华英汇[1] 陈世益[1] 李云霞[1] 

机构地区：[1]复旦大学附属华山医院运动医学科,上海200040

出　　处：《第三军医大学学报》2015年第3期207-210,共4页Journal of Third Military Medical University

摘　　要：目的评价关节镜下距下关节融合术治疗终末期距下关节炎的临床疗效。方法 2008年10月至2013年10月本科以关节镜下距下关节融合术治疗终末期距下关节炎共14例14踝,其中男性12例,女性2例,平均年龄35.5岁。包括创伤性关节炎11例,类风湿性关节炎3例。术中采用后侧入路,全镜下切除后距下关节软骨面及部分软骨下骨面。在骨面上微骨折后,透视引导下置入2枚直径7.0 mm的空心螺钉进行固定。术前及术后随访AOFAS评分及VAS评分。结果 14例患者均获得随访,随访时间平均41个月。术后8周X线片显示后距下关节均已获得骨性融合。AOFAS评分从术前53.8分改善至术后89.2分,VAS评分从术前7.8分降低至术后1.5分。结论全关节镜下距下关节融合术治疗终末期距下关节炎融合率高,并发症少,可以获得良好的临床疗效。Objective To evaluate the clinical outcome of arthroscopic subtalar arthrodesis for terminal subtalar arthritis. Methods Totally 14 patients（ 14 ankles） with isolated terminal subtalar arthritis receiving arthroscopic subtalar arthrodesis in our department from October 2008 to October 2013 were enrolled in this study. There were 12 males and 2 females,with an average age of 35. 5,and 11 patients with traumatic arthritis and 3 with rheumatoid arthritis. During the operation,the cartilage and partial subchondral bone were resected arthroscopically using the posterior portals. After the micro-fracture in the joint face,2 cannulated screws in diameter of 7. 0 mm were inserted for fixation by the monitor of the C-arm. American Orthopaedic Foot and Ankle Society（ AOFAS） score and visual analogue scale（ VAS） were employed pre- and prooperatively to evaluate the outcome. Results All the 14 patients were followed up at for an average time of41 months. X-ray films indicated that all of the patients got the bony fusion of subtalatr joint in 8 weeks after surgery. AOFAS score was improved from 53. 8 pre-operatively to 89. 2 post-operatively. VAS was improved from 7. 8 pre-operatively to 1. 5 post-operatively. Conclusion Arthroscopic subtalar arthrodesis will obtain a satisfactory surgical outcome for the treatment of terminal subtalar arthritis,with higher fusion rate and fewer complications.

关 键 词：距下关节融合 关节镜 终末期距下关节炎 

分 类 号：R681.8[医药卫生—骨科学] R684.3[医药卫生—外科学]