踝上截骨与踝关节融合术在创伤性踝关节炎患者治疗中的应用  

Application of Supra-ankle Osteotomy and Ankle Fusion in the Treatment of Patients with Traumatic Ankle Arthritis

作　　者：蔡蔚 范文俊[1] 付帅洲 赵进喜[1] CAI Wei;FAN Wenjun;FU Shuaizhou;ZHAO Jinxi(Department of Orthopedic Surgery,Macheng People's Hospital,Macheng,Hubei Province,438300 China)

机构地区：[1]麻城市人民医院骨外科,湖北麻城438300

出　　处：《系统医学》2023年第7期135-138,155,共5页Systems Medicine

摘　　要：目的围绕创伤性踝关节炎患者,分别采用踝上截骨术、踝关节融合术这两种方法来治疗,评定其临床效果与最终价值。方法选取2020年12月—2021年12月麻城市人民医院骨科收治的90例创伤性踝关节炎患者为研究对象,按照随机数表法分为两组,每组45例。A组行踝上截骨术,B组实施踝关节融合术,对比两组围术期指标、术后并发症情况,另就两组患者的疼痛评分(VAS)、踝关节评分标准(Kofoed)评分进行对比。结果B组术中出血量较A组更少,手术时间、术后关节融合时间、住院时间较A组均更短,差异有统计学意义(t=10.697、5.113、9.248、12.227,P<0.05)。术后6个月,B组VAS评分比A组更低,Kofoed评分较A组更高,差异有统计学意义(t=27.487、3.809,P<0.05)。B组术后并发症发生率(4.44%)较A组(20.00%)更低,差异有统计学意义(χ^(2)=5.074,P<0.05)。结论针对经检查予以确诊的创伤性踝关节炎患者,采用踝关节融合术治疗,较之踝上截骨术,术中出血更少,术后恢复速度更快,且疼痛更轻,并发症更少,功能恢复更理想。Objective To evaluate the clinical effect and final value of the two methods of supra-ankle osteotomy and ankle fusion for the treatment of patients with traumatic ankle arthritis.Methods 90 patients with traumatic ankle arthritis admitted to the orthopedics department of Macheng City People's Hospital from December 2020 to December 2021 were selected as the research objects and divided into two groups using a random number table method,with 45 patients in each group.Group A underwent supramalleolar osteotomy,while group B underwent ankle arthrodesis.The perioperative indicators and postoperative complications of the two groups were compared,and the pain score(VAS)and ankle joint score standard(Kofoed)scores of the two groups of patients were also compared.Results The intraoperative bleeding in group B was less than that in Group A,and the surgical time,postoperative joint fusion time,and hospital stay were all shorter than those in Group A,the difference was statistically significant(t=10.697,5.113,9.248,12.227,P<0.05).At 6 months after surgery,the VAS score of group B was lower than that of group A,and the Kofoed score was higher than that of group A,the difference was statistically significant(t=27.487,3.809,P<0.05).The incidence of postoperative complications in group B(4.44%)was lower than that in group A(20.00%),and the difference was statistically significant(χ^(2)=5.074,P<0.05).Conclusion For patients with traumatic ankle arthritis diagnosed by examination,treatment with ankle fusion is associated with less intraoperative bleeding,faster postoperative recovery,less pain,fewer complications,and better functional recovery than supra-ankle osteotomy.

关 键 词：创伤性踝关节炎 踝上截骨 踝关节融合术 

分 类 号：R687.4[医药卫生—骨科学]