跟骨截骨配合距舟关节融合治疗Muller-Weiss病疗效分析  

Effect of Calcaneal Osteotomy Combined with Talonavicular Joint Fusion on Muller-Weiss Disease

作　　者：张宏斌[1] 荣锦[1] 张立峰[1] 刘婷婷 关鹏飞[1] 王禹 张奉琪[2] ZHANG Hong-bin;RONG Jin;ZHANG Li-feng;LIU Ting-ting;GUAN Peng-fei;WANG Yu;ZHANG Feng-qi(The Fifth Department of Trauma,the Second Hospital of Tangshan,Tangshan 063000,China;Department of Podiatry,the Third Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]唐山市第二医院创伤五科,河北唐山063000 [2]河北医科大学第三医院足外科,石家庄050000

出　　处：《南昌大学学报（医学版）》2023年第3期39-43,共5页Journal of Nanchang University：Medical Sciences

基　　金：河北省2020年度医学科学研究课题计划(20201451)。

摘　　要：目的观察跟骨截骨配合距舟关节融合治疗Muller-Weiss病的效果。方法选取2017年8月至2020年8月唐山市第二医院Muller-Weiss病患者81例,根据手术方案不同分为对照组(n=40)和观察组(n=41),对照组行距舟关节融合治疗,观察组行跟骨截骨配合距舟关节融合治疗。采用美国足踝外科医师协会评分法(AOFAS)评估2组术前、术后足踝功能;视觉模拟评分法(VAS)评估2组术前、术后疼痛程度。比较2组足部解剖参数[侧位距骨-第1跖骨角(MA)、跟骨倾斜角(PA)、后足力线角(HAA)]及并发症情况。结果术后6、12个月观察组AOFAS评分、MA、PA、HAA均高于对照组,VAS评分均低于对照组(均P<0.05);术后12个月,观察组足踝功能恢复优良率高于对照组(92.68%比75.00%,P<0.05);2组并发症发生率比较,差异无统计学意义(P>0.05)。结论跟骨截骨配合距舟关节融合治疗Muller-Weiss病有助于矫正足踝畸形,改善足踝功能。Objective To investigate the effect of calcaneal osteotomy combined with talonavicular joint fusion on Muller-Weiss disease.Methods A total of 81 patients with Muller-Weiss disease admitted to the Second Hospital of Tangshan from August 2017 to August 2020 were treated with talonavicular joint fusion alone(control group,n=40)or in combination with calcaneal osteotomy(observation group,n=41).The foot and ankle functions were evaluated using the American Orthopedic Foot and Ankle Society(AOFAS)scores,and the pain degree was assessed using the Visual analogue scale(VAS).Anatomical foot parameters(lateral talus-first metatarsal angle(MA),calcaneal inclination angle(PA)and hindfoot alignment angle(HAA))and complications were compared between the two groups.Results At 6 and 12 months after operation,compared with the control group,the AOFAS scores,MA,PA,and HAA of the observation group increased,and the VAS scores of the observation group decreased.At 12 months after surgery,the excellent rate of functional recovery of the foot and ankle in the observation group was higher than that in the control group(92.68%vs 75.00%,P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Calcaneal osteotomy combined with talonavicular joint fusion for Muller-Weiss disease is beneficial to correct ankle deformities and improve ankle function.

关 键 词：Muller-Weiss病 距舟关节融合术 跟骨截骨 足踝部功能 足部解剖参数 并发症 

分 类 号：R684[医药卫生—骨科学]