关节成型术治疗Freiberg病短期临床效果的评价  

Short-term clinical curative effect of arthroplasty in treatment of Freiberg disease

作　　者：王骥[1] 徐子涵 汤宇 邹魁 冯曼玲 戴鹤玲[1] 

机构地区：[1]北京军区总医院骨科,北京100007 [2]武警河北总队干休所

出　　处：《中国骨与关节损伤杂志》2015年第4期393-395,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的观察并评价关节成型术治疗Freiberg病的短期临床效果。方法自2009-08—2013-04采用关节成型术治疗Freiberg病15例（16足）。参考Smillie分期：Ⅲ期5足,Ⅳ期7足,Ⅴ期4足。采用美国足踝外科协会（AOFAS）评分系统对不同Smillie分期患者手术前后的疼痛、功能、外观3个方面进行临床评价。结果本组均获得随访6~22个月,平均13.6个月。术后无切口感染及延迟愈合发生,关节间隙维持正常,患足外观正常,无转移性跖骨下疼痛。术后关节疼痛均明显改善,跖趾关节活动度较术前明显增大,差异有统计学意义（P〈0.05）。末次随访时,除了SmillieⅢ期患者功能评分与术前差异无统计学意义外（P〉0.05）,其余患者疼痛、功能、外观评分均较术前明显提高（P〈0.05）。结论关节成型术治疗中晚期Freiberg病均有满意疗效,是一种可靠的术式。Objective To observe and evaluate the short-term clinical curative effect of arthroplasty in treatment of Freiberg disease. Methods From August 2009 to April 2013, arthroplasty was performed on 15 patients with Freiberg disease（16 feet）.According to the Smillie classification, 5 feet had grade Ⅲ osteonecrosis, 7 feet grade Ⅳ osteonecrosis and 4 feet grade Ⅴosteonecrosis. The AOFAS system scoring was used for clinical evaluation of different stages of Smillie classification in pain,function and appearance. Results All the patients were followed up for an average of 13.6 months（6 to 22 months）. There were no postoperative infection and delayed union, metatarsophalangeal joint space and appearance of affected feet kept normal, and metastatic pain didn’t occur after operation. The complaint of pain with joint motion was decreased and the postoperative passive range of motion of joints improved significantly in all patients（ P 〈0.05）. The scores of pain, function and appearance were significantly improved after operation（P 〈0.05） except function score of grade Ⅲ osteonecrosis（P 〉0.05）finally. Conclusion Arthroplasty yields satisfied short-term results in interim and advanced stages Freiberg disease, and it’s effective to improve the range of motion and relieve pain of joint.

关 键 词：FREIBERG病 跖趾关节 关节成型术 

分 类 号：R687.42[医药卫生—骨科学]