双螺孔型重建板前路双关节融合术治疗黄土高原地区晚期踝大骨节病  

The anterior double-joint fusion with double perforated reconstructed plate for treatment of advanced ankle Kaschin-Beck disease in loess plateau region

作　　者：张国博 ZHANG Guo-bo(SectionⅢ,Dept of Orthopaedics,the People′s Hospital of Qingyang City,Qingyang,Gansu 745000,China)

机构地区：[1]庆阳市人民医院骨三科,甘肃庆阳745000

出　　处：《临床骨科杂志》2024年第4期519-521,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨双螺孔型重建板前路双关节融合术治疗黄土高原地区晚期踝大骨节病的疗效。方法采用双螺孔型重建板前路双关节融合术治疗36例黄土高原地区晚期踝大骨节病患者。记录手术情况、疼痛VAS评分、AOFAS踝-后足评分以及并发症发生情况。结果患者均获得随访,时间6~20(9.4±2.2)个月。手术时间50~60(55.0±5.0)min。切口均一期愈合,术后未发生断钉、断板等并发症。疼痛VAS评分及AOFAS踝-后足评分:术后6个月、末次随访时均较术前改善(P<0.05)。末次随访时,X线片显示踝关节植骨均融合,患侧外观正常,患肢行走无明显不适感;采用AOFAS踝-后足评分评价疗效:优30例、良6例,优良率100%。结论采用双螺孔型重建板前路双关节融合术治疗黄土高原地区晚期踝大骨节病,术中能够充分处理关节面,实现坚强固定,术后能够较好地恢复和维持踝关节的矫形位置,并发症少,疗效满意。Objective To investigate the effect of double-joint fusion with double perforated reconstruction plate in the treatment of advanced ankle Kaschin-Beck disease(KBD)in loess plateau region.Methods The 36 patients with advanced ankle KBD in loess plateau region were treated by double-joint fusion with double perforated reconstruction plate.The surgical status,pain VAS,AOFAS ankle-hindfoot score and complications were recorded.Results All patients were followed up for 6~20(9.4±2.2)months.The operation time was 50~60(55.0±5.0)min.All incisions healed in one stage,and no complications such as breakage of screws or plates occurred after operation.Pain VAS and AOFAS ankle-hindfoot scores were improved at 6 months and the last follow-up,compared with the preopation(P<0.05).At the last follow-up,X-rays showed that bone grafts in the ankle joint were all fused,the affected side appeared normal,and there was no obvious discomfort in walking on the affected limb.AOFAS ankle-hindfoot score was used to evaluate the curative effect,30 cases were excellent and 6 cases were good,the excellent-good rate was 100%.Conclusions In the treatment of advanced ankle KBD in loess plateau region,the double-joint fusion with double perforated reconstruction plate can fully treat the articular surface during the operation,which achieve firm fixation,recover and maintain the orthopedic position of the ankle well after surgery,with fewer complications and satisfactory efficacy.

关 键 词：双螺孔型重建板 双关节融合 黄土高原地区 踝大骨节病 

分 类 号：R684.7[医药卫生—骨科学] R687.3[医药卫生—外科学] R687.4[医药卫生—临床医学]