Swanson人工跖趾关节置换术治疗SmillieⅣ、V期Freiberg病的临床疗效观察  

Clinical efficacy of Swanson artificial metatarsophalangeal arthroplasty for treatment of Smillie Stage Ⅳand V Freiberg disease

作　　者：任泰超 李兵兵 杨智涛 鹿军 

机构地区：[1]西安市红会医院足踝外科诊疗中心综合病区,710054

出　　处：《美中国际创伤杂志》2023年第4期6-8,共3页U.S.Chinese International Journal of Traumatology

摘　　要：目的:探讨Swanson人工跖趾关节置换术治疗Smillie IV、V期Freiberg病的临床疗效。方法:回顾性分析2020年1月至2022年12月西安市红会医院足踝外科诊疗中心收治的Freiberg病患者资料,应用Swanson可屈曲铰链式硅胶跖趾关节假体实施人工跖趾关节置换第二跖趾关节手术20例。采用美国足踝外科协会Maryland跖趾关节百分评分系统、疼痛视觉模拟评分法(visual analogue scale,VAS)评分和美国足踝外科协会(American orthopedic foot and ankle society,AOFAS)踝-后足功能评分对疼痛、功能及客观体征进行评分。结果:20例获得随访,随访时间12-18个月,平均15.3个月。Maryland评分术前为42-74分,平均61.3分;术后为67-97分,平均93.1分。优16例(80.0%),良3例(15.0%),可1例(5.0%),手术优良率为95.0%。VAS平均评分从术前8.6(6-9)分改善到术后2.6(1-5)分,差异有统计学意义(P<0.05)。末次随访AOFAS评分为84.9(74-93)分,较术前57.2(42-68)分显著提高(P<0.05)。术后无伤口延迟愈合及伤口感染,无假体脱位,无反应性滑膜炎。结论:Swanson人工跖趾关节置换术治疗SmillieIV、V期Freiberg病的疗效较好,优良率高,可以保留跖趾关节功能,患者满意度高。Objective:To investigate the clinical effect of Swanson artificial metatarsophalangeal arthroplasty for treatment of Smillie Stage Ⅳ and V Freiberg disease.Methods:The data of Freiberg patients admitted to the foot and ankle surgery center of Xi'an honghui hospital from January 2020 to December 2022 were retrospectively analyzed.20 cases of artificial metatarsophalangeal joint replacement with Swanson flexible hinge silicone metatarsophalangeal joint prosthesis were performed.The pain,function and objective signs were scored by the American association of ankle surgery in Maryland plantar toe joint percentage grading system,visual analog pain score(visual analogue scale,VAS)and the American association of ankle surgery(American orthopedic foot and ankle society,AOFAS)Ankle-hind foot function score.Results:20 cases were followed up for 12-18 months(mean 15.3 months).The Maryland scores was 42-74 before surgery.with an average of 61.3,and was 67-97 after surgery,with an average of 93.1.There were 16 excellent cases((80.0%),3 good cases(15.0%)and 1 fair case(5.0%).The excellent and good rate of operation was 95.0%.The average VAS score improved from 8.6(6-9)before surgery to 2.6(1-5)after surgery,and the difference was statistically significant(P<0.05).The AOFAS score at the last fllow-up was 84.9(74-93)points,which was significantly higher than 57.2(42-68)points before operation(P<0.05).There was no de-layed wound healing,wound infection,prosthesis dislocation or reactive synovitis.Conclusion:Swanson arti-ficial metatarsophalangeal joint replacement is effective in the treatment of Smillie stage Ⅳ and V Freiberg disease,with a high rate of good and excellence,and the function of metatarsophalangeal joint can be pre-served with high patient satisfaction.

关 键 词：跖趾关节 关节置换 FREIBERG病 硅胶假体 

分 类 号：R68[医药卫生—骨科学]