Ilizarov外固定架在终末期复杂性踝关节炎融合术中的应用  

Application of Ilizarov External Fixator in the Arthrodesis of End-stage Complex Ankle Arthritis

作　　者：杨永强[1,2] 符长红 李福兵 姚玲[2] 万值颖 李军 YANG Yong-qiang;FU Chang-hong;LI Fu-bing;YAO Ling;WAN Zhi-ying;LI Jun(Kunming Medical University,Kunming Yunnan 650500;Dept. of Orthopedics,Kunming General Hospital of PLA,Kunming Yunnan 650032,China)

机构地区：[1]昆明医科大学,云南昆明650500 [2]解放军昆明总医院骨科,云南昆明650032

出　　处：《昆明医科大学学报》2017年第7期60-63,共4页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81171734)

摘　　要：目的对Ilizarov环形外固定架在终末期复杂性踝关节炎融合术中的临床效果进行分析.方法选取2013年1月至2014年5月,于解放军昆明总医院收的治终末期复杂性踝关节病损患者(n=19)为研究对象,行Ilizarov外固定架踝关节融合术,术后定期复查X线片.分别于术前及末次随访采用视觉模拟评分(VAS)评价、美国矫形足踝协会(AOFAS)的踝与后足评分.结果 19例患者术后获得8~30个月(平均14.7个月)随访,术中患者均未发生重要血管、神经损伤.末次随访时踝部疼痛明显缓解、畸形得到改善,X线提示所有患者均获得完全融合,融合时间11~16个周,平均14.7周.术前静息、负重VAS评分平均分别为4.9分、7.9分,术后分别为1.2分、1.9分,差异有统计学意义(P<0.001).AOFAS术前评分(58.74±4.00)分,术后末次随访为(93.21±4.47)分,差异有统计学意义(P<0.001).结论 Ilizarov环形外固定架在终末期复杂性踝关节炎融合术中疗效满意,具有持续提供轴向压应力,软组织创伤小,融合率高的优势.Objective To analyze the clinical effects of Ilizarov external fixation in arthrodesis on patients with end-stage complex ankle arthritis.Methods From January2013to May2014,19patients with end-stage complicated ankle arthritis in our hospital underwent ankle arthrodesis with Ilizarov external fixation.X-ray were conducted regularly after the operation.Clinical outcomes were evaluated by using the American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score and the Visual Analogue Scale(VAS)in pre-operation and the last follow-up.T-test was applied to analyze data.Results The19patients obtained an average follow-up of14.7months(ranging from6to25months),no injury to key vascular and nerves during operation.Ankle pain was obviously relieved,and deformity was improved significantly at the last follow-up.All patients achieved full arthrodesis according to the X-ray results after11to16weeks(average of14.7weeks).In the Visual Analogue Scale,preoperative resting state was scored4.9and the weight state was7.9,which were significantly reduced to1.2and1.9respectively after operation(P=0.000).In AOFAS ankle-hindfoot score,the pre-operative score was58.74±4.00,which significantly increased to93.21±4.47in the last follow-up(P=0.000).Conclusions Ilizarov external fixator is effective in the arthrodesis of end-stage complex ankle arthritis.And its advantage shows in axial compression,smaller soft tissue injury,and higher fusion rate.

关 键 词：踝关节炎 踝关节融合 Ilizarow外固定架 

分 类 号：R681.8[医药卫生—骨科学]