两种踝关节前路融合内固定方式治疗创伤性踝关节炎的疗效比较  

Efficacy comparison of two kinds of anterior arthrodesis and internal fixation for treatment of traumatic ankle arthritis

作　　者：余爱玉[1] 郭林新[1] 练克俭[1] 张焕堂[2] 黄尊贤 

机构地区：[1]解放军第175医院全军骨科中心(厦门大学附属东南医院骨科),福建漳州363000 [2]福建中医药大学附属泉州市正骨医院

出　　处：《中国骨与关节损伤杂志》2015年第12期1287-1289,共3页Chinese Journal of Bone and Joint Injury

基　　金：解放军总后勤部科技攻关项目(08G026)

摘　　要：目的 比较前路双重建钢板与前路海鸥形锁定钢板内固定踝关节融合术治疗创伤性踝关节炎的临床疗效。方法笔者自2007-02—2014-03诊治53例创伤性踝关节,28例采用前路双重建钢板进行固定融合（双重建钢板组）,25例采用前路海鸥形锁定钢板进行固定融合（海鸥形锁定钢板组）。结果 双重建钢板组获得平均17.2（12-29）个月随访,海鸥形锁定钢板组获得平均16.7（13-26）个月随访;2组出血量、手术时间、术前AOFAS评分比较差异均无统计学意义（P〉0.05）;末次随访2组AOFAS评分分别为（73.2±7.3）分和（84.3±6.2）分,差异有统计学意义（P〈0.05）。双重建钢板组平均融合时间14.3（8-25）周,海鸥形锁定钢板组为12.5（8-16）周,2组比较差异有统计学意义（P〈0.05）;双重建钢板组2例出现融合端延迟愈合,1例出现切口表浅感染,并发症发生率为10.7%。海鸥型锁定钢板组1例因患者过早下地负重行走出现内固定物断裂,并发症发生率为4%。结论 采用前路海鸥型锁定钢板固定踝关节融合术治疗创伤性踝关节炎,较前路双重建钢板固定融合时间短,具有更好的近期临床疗效,且并发症更少。Objective To compare the clinical efficacy of double reconstraction plate fixation and seagull-shape locking plate fixation in anterior ankle arthrodesis. Methods From Feb. 2011 to Mar. 2013, 53 patients with traumatic ankle arthritis were treated by our team. Twenty eight cases of them were treated with anterior double reconstraction plate fixation（double plate group）, while 25 cases were treated with anterior seagull-shape locking plate fixation（seagull-shape locking plate group） for the corresponding period. Results The mean follow-up of double plate fixation group was 17.2 months（range, 12-29 months）,while seagull-shape locking plates fixation was 16.7 months（range, 13-26 months）. There were no significant differences between two groups in operation time,amount of bleeding and AOFAS score before operations（P〉0.05）. While after surgery,the AOFAS score of two groups were（73.2 ±7.3） and（84.3 ±6.2） respectively, between the two groups with significant difference（P〈0.05）. The mean ankle fusion time was 14.3 weeks（range, 8 to 25 weeks） in double plate fixation group while12.5 weeks（range, 8 to 16 weeks） in seagull-shape locking plate fixation group, between the two groups with significant difference（P〈0.05）. In double plate fixation group, delayed union occurred in 2 cases and superficial infection in one case,the total complication rate was 10.7%. One patient in seagull-shape locking plate fixation group had broken internal fixation due to too early weight bearing walking. The complication rate was 4% in seagull-shape locking plate fixation group.Conclusion Compared double reconstraction plate fixation and seagull-shape locking plates fixation for treatment of traumatic ankle arthritis, seagull-shape locking plate fixation can obtain a shorter fusion time and a better clinical outcome,moreover, its complication rate is also lower.

关 键 词：创伤性踝关节炎 关节融合术 海鸥形锁定钢板 

分 类 号：R684.3[医药卫生—骨科学]