两种内踝截骨术在治疗Hepple V期距骨骨软骨损伤中的疗效对比  

Comparison of two kinds of medial malleolar osteotomy in the treatment of osteochondral injury of talus in stage Hepple V

作　　者：李雅娟 杨登军 宁梓文 何任杰 张红[2] 王福科[1] LI Yajuan;YANG Dengjun;NING Ziwen;HE Renjie;ZHANG Hong;WANG Fuke(Dept.of Sports Medicine,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032,China;Dept.of Psychiatry,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032,China)

机构地区：[1]昆明医科大学第一附属医院运动医学科,云南昆明650032 [2]昆明医科大学第一附属医院精神科,云南昆明650032

出　　处：《云南医药》2023年第3期16-19,共4页Medicine and Pharmacy of Yunnan

基　　金：云南省骨关节疾病临床医学中心项目[ZX-2019-03-04];云南省高层次人才培养支持计划“名医专项”(RLMY2020009)。

摘　　要：目的分析Chevron截骨与斜型截骨在自体骨软骨移植治疗Hepple V期距骨骨软骨损伤的疗效比较。方法15例患者为Chevron截骨组,15例患者为斜型截骨组,2组患者术前及术后均采用AOFAS评分及VAS评分进行临床功能评估比较,同时比较2组手术时长。结果30例患者均获1年随访,无不良并发症发生;2组患者手术时长比较:Chevron截骨可明显降低手术时长(P<0.05);30例患者术后一年AOFAS评分与VAS评分与术前相比较有显著差异(P<0.05),2组之间术前与术后一年AOFAS评分与VAS评分相比较无差异(P>0.05)。结论Chevron截骨与斜型截骨在自体骨软骨移植治疗Hepple V期距骨骨软骨损伤均取得了满意的临床疗效,两方法在术后一年的临床疗效无明显差异,但Chevron截骨的方法可减少手术时间,获得更好的手术暴露视野。Objective To compare the efficacy of Chevron osteotomy and oblique osteotomy in the treatment of talus osteochondral injury in Hepple V stage.Methods 15 patients were in the Chevron osteotomy group and 15 patients were in the oblique osteotomy group.AOFAS score and VAS score were used to evaluate the clinical function of the two groups before and after operation,and the operation time of the two groups was compared.Results All of the 30 patients were followed up for 1 year,and there were no adverse complications.The operation time of Chevron osteotomy could significantly reduced the operation time(P<0.05).There was significant difference in AOFAS score and VAS score one year after operation between the two groups(P<0.05).There was no significant difference between AOFAS score and VAS score before and one year after operation.(P>0.05).Conclusions Both Chevron osteotomy and oblique osteotomy have satisfactory clinical effects in the treatment of talus osteochondral injury in Hepple V stage.There is no significant difference between the two methods one year after operation,but Chevron osteotomy can reduce the operation time and obtain better surgical exposure field.

关 键 词：内踝截骨术 距骨骨软骨损伤 自体骨软骨移植 Hepple分期 

分 类 号：R687.3[医药卫生—骨科学]