距舟楔骨融合术治疗Müller-Weiss病:20例5年中期随访  

Talonavicular‑cuneiform arthrodesis for the treatment of Müller‑Weiss:mid‑term follow-up of 20 cases after 5 years

作　　者：邹保利 白文博 张凯亭 莫方东 李卓 沈国栋[2] 赖志斌 朱永展[2] Zou Baoli;Bai Wenbo;Zhang Kaiting;Mo Fangdong;Li Zhuo;Shen Guodong;Lai Zhibin;Zhu Yongzhan(The Eighth Clinical School of Medicine,Guangzhou University of Traditional Chinese Medicine,Guangzhou 510006,China;Foshan Hospital of Traditional Chinese Medicine,Foshan 528051,China)

机构地区：[1]广州中医药大学第八临床医学院,广州510006 [2]佛山市中医院,广东佛山528051

出　　处：《中国临床解剖学杂志》2024年第4期457-462,共6页Chinese Journal of Clinical Anatomy

摘　　要：目的探讨距舟楔关节融合治疗Müller-Weiss病至少5年中期随访的临床疗效。方法回顾性分析2015年1月至2018年8月于我院行距舟楔关节融合治疗的Müller-Weiss病20例(20足)患者,并评估其影像学参数(术前、术后3个月和末次随访)、临床疗效(术前、术后两年和末次随访)及并发症。结果20例患者均获得随访,平均随访时间为(72.05±8.86)月(60~93月),跟骨Pitch角(calcaneal pitch angle,CPA)、侧位Meary's角(Tomeno-Mearyangle,TMA)、前后位(AP)Meary's角、距舟覆盖角(talonavicular coverage angle,TCA)在术前和术后3个月存在显著差异(P<0.05),术后3个月的影像学结果与最终随访时无显著性差异(P>0.05)。末次随访时AOFAS和VAS评分较术前及术后两年均显著改善(P<0.05)。3名患者出现早期并发症,5名患者出现晚期并发症,1名患者接受了第二次手术(跟骨截骨术)治疗。结论距舟楔关节融合结合自体髂骨取骨植骨治疗Müller-Weiss病疗效可靠,并且其疗效可以维持到中期随访。Objective To investigate the clinical effect of talonavicular-cuneiform(TNC)arthrodesis in the treatment of Müller-Weiss disease(MWD)for at least 5 years mid-term follow-up.Methods A total of 20 patients undergoing TNC arthrodesis for MWD were retrospectively reviewed between January 2015 and August 2018.The radiographic parameters(preoperative,three months after the operation,and final follow-up),clinical results(preoperative,two years after the operation,and final follow-up)and complications were evaluated and analyze.Results The mean follow up period was 72.05±8.86 months(range 60 to 93).There were significant differences in the calcaneal pitch angle(CPA),Tomeno-Meary's angle(TMA),anteroposterior(AP)Meary's angle and talonavicular coverage angle(TCA)before operation and three months after operation(P<0.05).There was no significant difference in the radiographic results between three months after the operation and the final follow-up(P>0.05).The scores of AOFAS and VAS at the final follow-up were significantly improved compared with those before and two years after the operation(P<0.05).Three patients had early complications,five had late complications,and one patient was treated with a second operation(calcaneal osteotomy).Conclusions The treatment of MWD with talonavicular-cuneiform arthrodesis combined with iliac bone autograft is effective and can be maintained until mid-term follow-up.

关 键 词：Müller-Weiss病 距舟楔关节融合 髂骨植骨 中期随访 

分 类 号：R687.43[医药卫生—骨科学]