阶段性康复训练结合加压螺钉融合治疗创伤性踝关节炎的临床应用  

Staged rehabilitation training and compression screws in treatment of traumatic ankle sacroiliitis

作　　者：杨猛 宋远征 张峰[1] 张率功[1] 朱法豪 Yang Meng;Song Yuanzheng;Zhang Feng;Zhang Lyugong;Zhu Fahao(First Department of Traumatic Medicine, Tengzhou Central Hospital, Jining Medical University, Tengzhou 277500, China)

机构地区：[1]济宁医学院附属滕州市中心人民医院创伤一科,277500

出　　处：《国际医药卫生导报》2018年第18期2743-2746,共4页International Medicine and Health Guidance News

基　　金：济宁医学院教师科研扶持基金(JY2017FS039)

摘　　要：目的 探讨阶段性康复训练结合加压螺钉融合治疗创伤性踝关节炎的临床疗效。方法 笔者自2011年7月至2016年7月对本院29例终末期创伤性踝关节炎患者应用阶段性康复训练结合加压螺钉融合治疗,所有患者在术后6周、12周、24周及1年时各随访1次,术前术后采用美国矫形外科足踝协会(AOFAS)Maryland评价足踝部功能,随访时记录患者术后并发症。结果 所有患者均未出现内固定断裂、松动,伤口感染、血栓栓塞等并发症,没有患者需要去除螺钉或接受进一步的翻修手术;2例患者诉平地行走有轻度疼痛,2例诉上坡时轻度疼痛;末次随访时患者AOFAS踝关节评分较术前显著改善,差异有统计学意义(t=-31.328,P<0.05);所有患者均获得骨性愈合,临床效果评价为优11例,良14例,可4例,差0例,优良率为86.2%。结论 阶段性康复训练结合加压螺钉融合治疗创伤性踝关节炎骨性愈合率高,并发症少,有助于患者踝关节功能的恢复,值得临床上推广。Objective To investigate the clinical effect of staged rehabilitation training combined with compression screws in the treatment of traumatic ankle sacroiliitis.Methods From July,2011to July,2016,twenty-nine patients with terminal traumatic arthritis of the ankles were treated with staged rehabilitation training and compression screws.All the patients were followed up6weeks,12weeks,24weeks,and1year after operation.The ankle functions were evaluated by the American Orthopaedic Foot and Ankle Society(AOFAS).Postoperative complications were recorded during follow-up.Results All patients had no complications such as internal fixation fracture,incision,wound infection,and thromboembolism.No patient needed to remove the screws or undergo further revision surgery.Two patients complained of mild pain when walking on flat ground,and two patients complained of mild pain when going uphill.The AOFAS score at the final follow-up was significantly better than that before operation,with a statistical difference(t=-31.328,P<0.05).All the patients received bony union.The clinical evaluation was excellent in11cases,good in14cases,fair in4cases,and poor in0case,with an excellent and good rate of86.2%.Conclusion For treating traumatic ankle sacroiliitis,staged rehabilitation training combined with compression screws can improve the rate of bone healing,reduce complications,and help the recovery of ankle function.It is worth for clinical promotion.

关 键 词：踝关节融合 加压螺钉 阶段性康复 创伤性踝关节炎 

分 类 号：R687.4[医药卫生—骨科学]