内翻型踝关节骨性关节炎踝上截骨术中保留腓骨与截断腓骨对疗效的影响  

Effect of preserved and truncated fibula on efficacy in supramalleolar ankle osteotomy for varus ankle osteoarthritis

作　　者：张文举[1] 张宇[1] 徐善强 李平[1] 王勇[1] 何凯元 ZHANG Wen-ju;ZHANG Yu;XU Shan-qiang;LI Ping;WANG Yong;HE Kai-yuan(Department of Foot and Ankle Surgery,Sichuan Province Orthopedic Hospital,Chengdu,Sichuan 610041,China)

机构地区：[1]四川省骨科医院足踝二科,四川成都610041

出　　处：《中国骨与关节损伤杂志》2022年第6期594-597,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的观察内翻型踝关节骨性关节炎踝上截骨术中保留腓骨与截断腓骨对疗效的影响。方法纳入自2018-02-2020-02采用踝上截骨术治疗的46例内翻型踝关节骨性关节炎,其中23例截断腓骨(截断腓骨组),23例保留腓骨(保留腓骨组)。比较两组截骨区骨愈合时间、并发症发生率,术后12个月踝与后足功能AOFAS评分,以及术后12个月踝关节影像学参数(TAS、TT、TC、TLS)。结果46例均获得至少12个月随访,截骨区均获得骨性愈合。截断腓骨组与保留腓骨组截骨区骨愈合时间、并发症发生率差异无统计学意义(P>0.05)。截断腓骨组、保留腓骨组术后12个月踝与后足功能AOFAS评分较术前明显改善,差异有统计学意义(P<0.05)。截断腓骨组与保留腓骨组术后12个月踝与后足功能AOFAS评分差异无统计学意义(P>0.05)。截断腓骨组与保留腓骨组术后12个月TAS、TLS比较差异无统计学意义(P>0.05);截断腓骨组TT小于保留腓骨组,而TC大于保留腓骨组,差异有统计学意义(P<0.05)。结论内翻型踝关节骨性关节炎踝上截骨术中保留腓骨与截断腓骨对截骨区骨性愈合时间、术后并发症发生率无明显影响,均可有效改善患者踝关节功能,而截断腓骨对内翻畸形的改善效果更佳。Objective To observe the effect of preserved and truncated fibula on efficacy in supramalleolar ankle osteotomy for varus ankle osteoarthritis.Methods Forty-six cases of varus ankle osteoarthritis treated with supramalleolar ankle osteotomy from February 2018 to February 2020 were included,including 23 truncated fibula(truncated fibula group)and 23 preserved fibula(preserved fibula group).The bone healing time,the complication rate,the AOFAS score of ankle and hind foot function at 12 months,and the ankle imaging parameters(TAS,TT,TC,TLS)were compared.Results All 46 patients received at least 12 months follow-up and had bone healing in the osteotomy areas.There was no significant difference in bone healing time and complication rate between the truncated and preserved fibula group(P>0.05).The AOFAS score of ankle and hind foot function in the truncated and preserved fibula group postoperative at 12 months was significantly improved after operation,with significant difference(P<0.05).There was no significant difference in AOFAS scores between ankle and hind foot function at 12 months between the truncated and preserved fibula groups(P>0.05).The difference between TAS and TLS in the truncated and preserved fibula groups was not significant(P>0.05);In the truncated group,TT was less than the preserved fibula group and TC was greater than the preserved group(P<0.05).Conclusion The preserved fibula and truncated fibula during varus ankle osteotomy have no obvious effect on the bone healing time of the osteotomy area and the incidence of postoperative complications,both can effectively improve the ankle function of patients,while the improvement effect of truncated fibular for the varus is better.

关 键 词：内翻型踝关节骨性关节炎 踝上截骨术 保留腓骨 截断腓骨 

分 类 号：R687.3[医药卫生—骨科学]