Ilizarov外固定踝融合术治疗终末期踝关节炎疗效分析  

Ankle Arthrodesis Using Ilizarov Fixator for Patients with end-stage Ankle Arthropathies

作　　者：王兴山[1] 黄野[1] 柳剑[1] 张纪[1] Wang Xingshan;Huang Ye;Liu Jian(Department of Orthopaedic Surgery,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院矫形骨科

出　　处：《实用骨科杂志》2019年第10期898-902,共5页Journal of Practical Orthopaedics

摘　　要：目的评价Ilizarov外固定架固定踝关节融合术治疗终末期踝关节炎的临床效果。方法对2016年5月至2017年12月我院行Ilizarov外固定架固定踝关节融合的20例终末期踝关节炎患者进行回顾性研究,其中男性12例,女性8例;年龄47~77岁,平均(59.05±7.83)岁。评估患者术后功能、融合成功率、并发症发生率以及合并畸形的矫正情况。结果所有患者均获得骨性愈合,融合成功率100%。术后愈合时间3~6个月,平均(3.70±1.04)个月。1例出现伤口延迟愈合,1例出现针道感染,1例出现严重肿胀及张力水疱,无其他严重并发症发生。胫骨长轴与距骨关节面的内侧夹角(medialtibialtalarangle,MTTA)由术前的(86.84±6.26)°增加到(89.90±1.37)°,距骨前移距离由(5.50±3.97)mm减小到(2.85±2.72)mm,与术前相比差异均有统计学意义(P<0.05)。术后踝关节功能也有明显改善,AOFAS踝与后足评分由术前的(39.00±8.34)分增加至术后的(80.65±8.86)分(P<0.001)。结论Ilizarov外固定架固定踝关节融合术,骨愈合成功率高,可矫正合并的踝关节对位及对线异常,有效地改善患者的踝关节功能,具有良好的效果。Objective To evaluate the outcome of ankle arthrodesis using Ilizarov fixator for patients with end-stage ankle arthropathies.Methods We retrospectively studied 20 patients who underwent ankle arthrodesis with Ilizarov external fixator from May 2016 to December 2017.Twelve male patients and 8 female patients were included.The mean age was(59.05±7.83)years old(range 47~77 years).Outcomes were measured by The American orthopaedic foot and ankle society(AOFAS)hindfoot score,rate of union,rate of complications,and alignment of the ankle joint.Results Ankle fusion was achieved in allpatients.The mean time to healing was(3.70±1.04)months(range 3~6 months).Delayed wound healing,stent-tract infection and severe swelling were presented in one patient separately.Medial tibial talar angle improved from(86.84±6.26)degrees pre-operatively to(89.90±1.37)degrees post-operatively(P<0.05).Lateral talar station decreased from(5.50±3.97)mm to(2.85±2.72)mm(P<0.05).AOFAS score improved significantly from(39.00±8.34)pre-operatively to(80.65±8.86)post-operatively(P<0.001).Conclusion Ankle arthrodesis using Ilizarov fixator can achieve good radiological and clinical outcomes for patients with end-stage ankle arthropathy,associated with low prevalence of ankle joint malalignment and high fusion rates.

关 键 词：外固定架 踝关节骨关节病 融合术 

分 类 号：R684.3[医药卫生—骨科学]