术前胫距关节间隙对保踝治疗术后预期结局的影响  

Effect of preoperative tibiotalar joint space on expected outcomes after ankle sparing surgery

作　　者：徐仲波 XU Zhongbo(Department of Radiology,Fuyang District Traditional Chinese Medicine Orthopaedic Hospital of Hangzhou,Hangzhou 320000,Zhejiang,China)

机构地区：[1]杭州市富阳中医骨伤医院放射科,浙江杭州320000

出　　处：《中国现代医生》2023年第4期57-60,共4页China Modern Doctor

摘　　要：目的分析术前胫距关节间隙对保踝治疗术后预期结局的影响。方法选取2012年3月至2018年4月于杭州市富阳中医骨伤医院行踝关节保留手术的患者258例,按照术前胫距关节间隙不同分为<2mm组与≥2mm组,运用倾向性评分匹配法对两组患者进行配对,比较匹配后两组患者术后末次随访时的预期结局。结果经倾向性评分匹配后,术前胫距关节间隙<2mm组与≥2mm组各纳入患者50例,两组患者的一般资料比较差异均无统计学意义(P>0.05),倾向性评分分布相似,匹配效果较好。术后末次随访时,≥2mm组患者距骨倾斜角及距骨前移距离均明显小于<2mm组,美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足评分、足踝能力评估量表(foot and ankle ability measure,FAAM)日常活动及运动评分均明显高于<2mm组(P<0.05);术前胫距关节间隙与距骨倾斜角和距骨前移距离呈负相关(r=–0.358、–0.320,P<0.05),与AOFAS踝-后足评分、FAAM日常活动及运动评分均呈正相关(r=0.404、0.385、0.340,P<0.05)。结论术前胫距关节间隙<2mm的患者行保踝治疗术后预期结局比≥2mm者差,可为术前临床决策提供参考。Objective To analyze the influence of preoperative tibiotalar joint space on the expected outcome after ankle salvage therapy.Methods A total of 258 patients who underwent ankle salvage therapy in Fuyang District Traditional Chinese Medicine Orthopaedic Hospital of Hangzhou from March 2012 to April 2018 were selected.According to the difference of preoperative tibiotalar joint space,they were divided into<2mm group and≥2mm group.The patients in two groups were matched by the propensity score matching method,and the expected outcome of the patients in two groups at the last postoperative follow-up was compared after matching.Results After matching the propensity score,50 patients were included in each group of preoperative tibial talus joint space<2mm and≥2mm,and there was no statistical significance in the comparison of general data between the two groups(P>0.05).The distribution of propensity score was similar and the matching effect was better.At the last postoperative follow-up,the inclination angle of the talus and the forward distance of the talus in≥2mm group were significantly smaller than those in the<2mm group,American Orthopedic Foot and Ankle Society(AOFAS)ankle hindfoot scale,daily activity and exercise scores of foot and ankle ability measure(FAAM)were significantly higher than those of<2mm group(P<0.05).The preoperative tibiotalar joint space was negatively correlated with the inclination angle of the talus and the forward distance of the talus(r=–0.358,–0.320,P<0.05),and positively correlated with AOFAS ankle hindfoot scale,daily activity and exercise scores of FAAM(r=0.404,0.385,0.340,P<0.05).Conclusion The expected outcome of patients with preoperative tibiotalar joint space<2mm after ankle salvage therapy is worse than those with≥2mm,which can provide reference for preoperative clinical decision-making.

关 键 词：踝关节 胫距关节间隙 保踝治疗术 关节功能 

分 类 号：R687.4[医药卫生—骨科学]