截骨复位治疗踝关节骨折畸形愈合的疗效分析  

Clinical outcomes of osteotomy reduction for malunited ankle fractures

作　　者：赖良鹏[1] 李莹[1] 孙宁[1] 王岩[1] 李恒 李文菁[1] 龚晓峰[1] 杜辉[1] 武勇[1] LAI Liangpeng;LI Ying;SUN Ning;WANG Yan;LI Heng;LI Wenjing;GONG Xiaofeng;DU Hui;WU Yong(Department of Foot and Ankle Surgery,Beijing Jishuitan Hospital(The 4th Medical College of Peking University),Beijing 100035,China)

机构地区：[1]北京大学第四临床医学院北京积水潭医院足踝外科,北京100035

出　　处：《中华骨与关节外科杂志》2023年第6期554-560,共7页Chinese Journal of Bone and Joint Surgery

基　　金：北京积水潭医院院级基金(QN-202208)。

摘　　要：目的:探讨采用截骨复位治疗踝关节骨折畸形愈合的临床疗效。方法:回顾性分析2018年3月至2021年6月收治的30例采用截骨复位治疗踝关节骨折畸形愈合的患者资料。男9例,女21例;手术时年龄18~70岁,平均(40.5±15.5)岁;受伤或第一次手术到截骨手术间隔9(6.3,22.5)个月。比较患者术前及末次随访时的美国足踝外科协会(AOFAS)踝与后足评分、疼痛视觉模拟评分(VAS)、足部功能指数(FFI)、距骨倾斜角(TT)、距踝角(TCA)和踝关节活动范围(ROM),记录患者满意度及并发症。结果:所有患者术后随访18~57个月,平均(40.5±12.0)个月。末次随访时AOFAS踝与后足评分为(86.5±7.6)分、VAS为1.0(1.0,2.0)分、FFI为18.5(9.2,23.8)分、TT为1.4°(1.0°,2.1°)、TCA为79.2°±3.3°,较术前均显著改善,差异有统计学意义(P<0.05)。踝关节ROM术前和末次随访比较,差异无统计学意义。1例踝关节炎发生了进展,总体满意度86.7%(26/30)。结论:采用截骨复位治疗踝关节骨折畸形愈合具有良好的临床疗效,满意度较高,可有效延缓关节炎进展。Objective:To evaluate the clinical outcomes of the osteotomy reduction for malunited ankle fractures.Methods:From March 2018 to June 2021,30 patients with malunited ankle fractures receiving osteotomy reduction were retrospectively reviewed,including 9 males and 21 females,aged from 18 to 70 years with the mean of(40.5±15.5)years.The interval between injury or first surgery to the osteotomy was 9(6.3,22.5)months.Comparisons were made between the pre-operation and the last follow-up in American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score,pain visual analogue scale(VAS),foot functional index(FFI),talar tilt(TT),talocrural angle(TCA)and ankle range of motion(ROM).Patients'satisfactions and complications were recorded.Results:All patients were followed up for 18 to 57 months with the mean of(40.5±12.0)months.At the last follow-up,the values of AOFAS,VAS,FFI,TT and TCA were(86.5±7.6),1.0(1.0,2.0),18.5(9.2,23.8),1.4°(1.0°,2.1°)and 79.2°±3.3°,with all significantly improved than that before operation(all P<0.05);ankle ROM was not different compared with that before operation however.One patient had his ankle arthritis progressed.The overall satisfaction rate was 86.7%(26/30).Conclusions:Osteotomy reduction for malunited ankle fracture has good clinical outcomes and high satisfaction rate,which can effectively postpone the progression of ankle arthritis.

关 键 词：踝关节骨折 畸形愈合 截骨 关节炎 

分 类 号：R683.42[医药卫生—骨科学]