经Chaput结节联合外踝倒“V”形截骨术治疗距骨外侧软骨损伤的疗效分析  

Effect analysis of lateral osteochondral lesions of the talus through Chaput tubercle combined with lateral malleolar inverted V-shaped osteotomy

作　　者：赵述傲 赵德勇 蒋健 王海波 冯骁 王龙 袁泉 Zhao Shuao;Zhao Deyong;Jiang Jian;Wang Haibo;Feng Yao;Wang Long;Yuan Quan(Department of Orthopedics,the Third Affilated Hospital of Soochow University,Changzhou 213000,Jiangsu,China;Department of Orthopedics,the Affilated Hospital of Xuzhou Medical University,Xuzhou 221002,Jiangsu,China)

机构地区：[1]苏州大学附属第三医院骨科,江苏常州213000 [2]徐州医科大学附属医院骨科,江苏徐州221002

出　　处：《足踝外科电子杂志》2024年第3期1-5,共5页Electronic Journal of Foot and Ankle Surgery

摘　　要：目的探讨通过经Chaput结节联合外踝倒“V”形截骨术治疗距骨外侧软骨损伤的临床疗效。方法回顾性分析2018年3月至2023年9月徐州医科大学附属医院收治的10例距骨外侧骨软骨损伤患者的资料,患者均采用经Chaput结节联合外踝倒“V”形截骨治疗。比较美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)的踝-后足评分、视觉模拟评分法(visual analogue scale,VAS)评分及影像学的变化,对术前、术后踝关节的功能和疗效进行评估。结果10例患者术后均获得6~24个月(平均13.8个月)的随访。末次随访时患者截骨处均愈合良好,无感染、畸形愈合、内固定断裂等并发症发生。末次随访时AOFAS踝-后足评分(93.2±3.2)分、VAS评分(5.4±1.5)分均较术前(47.5±5.7)分、(1.5±0.7)分显著改善,差异有统计学意义(P<0.05)。结论经Chaput结节联合外踝倒“V”形截骨治疗距骨外侧软骨损伤,可以充分显露距骨外侧病灶,术后疗效满意,并发症少,是一种安全、有效的治疗方法。Objective To investigate the clinical effect of the treatment of lateral osteochondral lesions of the talus through Chaput tubercle combined with lateral malleolar inverted V-shaped osteotomy.Methods A retrospective analysis was conducted on the data of 10 patients with lateral talus osteochondral injury admitted to the the Affilated Hospital of Xuzhou Medical University from March 2018 to September 2023.All patients were treated with Chaput nodule combined with lateral ankle inverted“V”osteotomy.Compare the ankle posterior foot score,visual analog scale(VAS)score,and imaging changes of the American Orthopaedic Foot and Ankle Society(AOFAS)to evaluate the preoperative and postoperative ankle joint function and efficacy.Results All 10 patients were followed up for 6~24(average 13.8)months after surgery.At the last follow-up,the patient’s osteotomy site healed well without any complications such as infection,malunion,or internal fixation fracture.At the last follow-up,the AOFAS ankle hind foot score(93.2±3.2)points and VAS score(5.4±1.5)points were significantly improved compared to preoperative scores(47.5±5.7)points and(1.5±0.7)points,with statistical significance(P<0.05).Conclusion The combination of Chaput nodule and lateral ankle inverted“V”osteotomy for the treatment of lateral cartilage injury of the talus can fully expose the lesions on the lateral side of the talus,with satisfactory postoperative efficacy and few complications.It is a safe and effective treatment method.

关 键 词：距骨软骨损伤 Chaput结节 外踝截骨 髂骨移植 

分 类 号：R681[医药卫生—骨科学]