应用步态分析系统评估踝上截骨术治疗内翻型踝关节炎的临床效果  

Evaluation of SMOT for the treatment of varus ankle arthritis using a gait analysis system

作　　者：冯凤鸣 崔亮[2] 陶世武 石明鑫 张网 杨宗宇 FENG Feng-ming;CUI Liang;TAO Shi-wu;SHI Ming-xin;ZHANG Wang;YANG Zong-yu(Graduate School of Hebei University of Traditional Chinese Medicine,Shijiazhuang 050091,China;The Second Department of Foot and Ankle Surgery,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Province,Cangzhou 061000,China;Gait Analysis Laboratory,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Province,Cangzhou 061000,China)

机构地区：[1]河北中医药大学研究生学院,河北石家庄050091 [2]河北省沧州中西医结合医院足踝二科,河北沧州061000 [3]河北省沧州中西医结合医院步态分析室,河北沧州061000

出　　处：《河北医科大学学报》2025年第4期393-399,共7页Journal of Hebei Medical University

基　　金：河北省“三三三人才工程”资助项目(C20231045)。

摘　　要：目的通过步态分析系统评估踝上截骨术(supramalleolar osteotomy,SMOT)治疗内翻型踝关节炎的临床效果。方法回顾性分析2020年1月—2023年12月河北省沧州中西医结合医院足踝外科收治的接受SMOT的踝关节炎患者95例。经严格按照纳入标准和排除标准筛选后,共纳入患者78例。比较患者术前术后步态分析相关数据、美国足踝外科协会(American Orthopaedic Foot&Ankle Society,AOFAS)踝-后足评分、疼痛视觉模拟评分(visual analogue scale,VAS)、胫骨远端关节面角(tibial articular surface angle,TAS)和胫骨侧面关节面角(tibial lateral surface angle,TLS)。结果术后12个月,患者AOFAS踝-后足评分[(85.49±2.21)分]、步长[(110.61±2.02)cm]、步速[(100.19±2.05)cm/s]、足平衡平均值[(16.22±8.66)N]、矢状面活动角度[(22.53±1.12)°]、TAS角[(90.17±0.76)°]、TLS角[(80.09±0.98)°]高于术前[(49.68±2.75)分、(71.06±2.87)cm、(76.28±2.01)cm/s、(-36.73±13.98)N、(15.66±1.50)°、(77.87±1.86)°、(76.99±0.63)°],VAS评分[(1.77±0.49)分]低于术前[(6.22±0.47)分],差异有统计学意义(P<0.001)。结论基于步态分析系统的检查结果,SMOT在治疗内翻型踝关节炎方面显示出良好的矫正效果和截骨愈合情况,显著提升了患者的踝关节功能。Objective To assess the clinical efficacy of supramalleolar osteotomy(SMOT)in the treatment of varus ankle arthritis using a gait analysis system.Methods A retrospective analysis was conducted on 95 patients with ankle arthritis who underwent SMOT at the Department of Foot and Ankle Surgery,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province from January 2020 to December 2023.After strict screening based on inclusion and exclusion criteria,78 patients were finally included.Preoperative and postoperative data on gait analysis,American Orthopaedic Foot&Ankle Society(AOFAS)Ankle-Hindfoot Score,visual analogue scale(VAS)pain scores,tibial articular surface angle(TAS),and tibial lateral surface angle(TLS)were compared.Results At 12 months postoperatively,patients′AOFAS ankle-hindfoot scores[(85.49±2.21)points],step length[(110.61±2.02)cm],gait speed[(100.19±2.05)cm/s],mean value of foot balance[(16.22±8.66)N],range of motion in sagittal plane[(22.53±1.12)°],TAS angle[(90.17±0.76)°],and TLS angle[(80.09±0.98)°]were higher than preoperative values[(49.68±2.75)points,(71.06±2.87)cm,(76.28±2.01)cm/s,(-36.73±13.98)N,(15.66±1.50)°,(77.87±1.86)°,(76.99±0.63)°],while VAS scores[(1.77±0.49)points]were lower than preoperative scores[(6.22±0.47)points],with significant differences(P<0.001).Conclusion Based on the findings of the gait analysis system,SMOT shows good corrective effects and osteotomy healing in varus ankle arthritis,significantly improving ankle function.

关 键 词：关节炎 踝上截骨术 步态分析 

分 类 号：R687.4[医药卫生—骨科学]