自体带骨膜髂骨移植术治疗距骨骨软骨损伤的疗效观察  

Effect of Autogenous Periosteum Iliac Bone Grafting on Osteochondral Injury of Talus

作　　者：刘核达[1] 刘林 黄飞 李鹏伟 李明 刘胜 李森田[1] LIU Heda;LIU Lin;HUANG Fei;LI Pengwei;LI Ming;LIU Sheng;LI Sentian(Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province,Cangzhou 061013,Hebei China)

机构地区：[1]河北省沧州中西医结合医院,河北沧州061013

出　　处：《中国中医骨伤科杂志》2025年第2期81-85,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：河北省中医药管理局2020年度中医药类科研计划项目(2020508)。

摘　　要：目的:分析自体带骨膜髂骨移植术对距骨骨软骨损伤(OLT)患者影像学检查结果和踝关节功能的影响。方法:选择2018年1月至2022年11月收治的距骨骨软骨损伤122例患者病例资料,均行自体带骨膜髂骨移植术,比较患者术前和术后关节活动度、关节功能、关节疼痛程度及并发症情况。结果:患者术后6个月总有效率(82.79%)显著低于术后12个月(93.44%),差异有统计学意义(P<0.05);术后6个月和12个月主动屈伸关节活动度(ROM)、踝-后足评分系统(AOFAS)总分显著高于术前,差异有统计学意义(P<0.05),视觉模拟量表(VAS)评分显著低于术前,差异有统计学意义(P<0.05);且患者术后12个月关节活动度水平和AOFAS评分显著高于术后6个月,差异有统计学意义(P<0.05),VAS评分显著低于术后6个月,差异有统计学意义(P<0.05);患者术后影像学检查结果显示距骨软骨下囊肿消失,移植区无异常,均未发生不良反应。结论:距骨骨软骨损伤患者自体带骨膜髂骨移植术治疗,可控制病情发展,有助于踝关节功能恢复,降低疼痛程度,效果较为理想,临床应用价值较高。Objective:To explore and analyze the impacts of autologous periosteal iliac bone transplantation on imaging results and ankle joint function in patients with osteochondral lesion of the talus(OLT).Methods:A total of 122 OLT patients admitted from January 2018 to November 2022 were selected,all of whom underwent autologous periosteal iliac bone transplantation.The preoperative and postoperative joint range of motion(ROM),joint function,degree of joint pain,and complications of patients were compared.Results:The total effective rate of patients at 6 months post surgery(82.79%)was obviously lower than that at 12 months post surgery(93.44%)(P<0.05);after 6 and 12 months of surgery,the total scores of active flexion and extension joint ROM and ankle hind foot scoring system(AOFAS)were obviously higher than before surgery(P<0.05),and the total score of visual analogue scale(VAS)was obviously lower than before surgery(P<0.05);moreover,the ROM level and AOFAS score of the patients were obviously higher at 12 months post surgery than at 6 months post surgery(P<0.05),while the VAS score was obviously lower at 6 months post surgery(P<0.05);and the postoperative imaging results of the patient showed that the subchondral cyst of the talus disappeared,there were no abnormalities in the transplantation area,and no adverse reactions occurred.Conclusion:Autologous transplantation of iliac bone with periosteum can effectively control the progression of OLT patients,aid in ankle joint function recovery,reduce pain levels,and achieve ideal results,with high clinical application value.

关 键 词：距骨骨软骨损伤 自体带骨膜髂骨移植术 踝关节功能 疼痛 并发症 

分 类 号：R687.3[医药卫生—骨科学]