经前侧入路与经外侧入路行钢板内固定踝关节融合术治疗踝关节骨性关节炎的效果比较  

Ankle arthrodesis by internal fixation with plate in the treatment of ankle osteoarthritis:a comparison of anterior approach and lateral approach

作　　者：刘晓东[1] 赵建磊 李健阳 Liu Xiaodong;Zhao Jianlei;Li Jianyang(Department of Foot and Ankle Surgery,Luoyang Orthopedic-Traumatological Hospital of Henan Province,Henan Provincial Orthopedic Hospital,Zhengzhou 450016,China)

机构地区：[1]河南省洛阳正骨医院、河南省骨科医院足踝外科,郑州450016

出　　处：《中国实用医刊》2025年第4期10-13,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较经前侧入路与经外侧入路行钢板内固定踝关节融合术治疗踝关节骨性关节炎的临床效果。方法回顾性抽取2020年1月至2023年1月河南省洛阳正骨医院收治的踝关节骨性关节炎患者82例,依据手术入路方式将其分为前侧组(42例,经前侧入路行钢板内固定踝关节融合术)和外侧组(40例,经外侧入路行钢板内固定踝关节融合术)。比较两组切口长度、手术时间、术后引流量、骨折愈合时间、美国骨科足踝学会(AOFAS)评分、术后距骨倾斜角及跟骨补偿角、血清前列腺素E2(PGE2)水平、P物质水平及并发症发生情况。结果前侧组切口长度、手术时间、骨折愈合时间短于外侧组(P<0.05);两组术后引流量比较差异未见统计学意义(P>0.05)。术后,两组PGE2及P物质水平低于术前,且前侧组低于外侧组(P<0.05)。术前,两组AOFAS评分比较差异未见统计学意义(P>0.05);术后3、6、12个月,两组AOFAS评分呈增高趋势(P<0.05)。AOFAS评分在不同时间点、组间、交互层面比较,差异有统计学意义(P<0.05)。术后,两组距骨倾斜角及跟骨补偿角高于术前,且前侧组高于外侧组(P<0.05)。两组术后均未出现严重并发症。结论与经外侧入路比较,经前侧入路实施锁定钢板内固定踝关节融合术,更有助于减少术后疼痛反应,促进术后骨愈合及踝关节功能的恢复。ObjectiveTo compare the clinical effects of ankle arthrodesis by internal fixation with plate via anterior and lateral approaches in the treatment of ankle osteoarthritis.MethodsEighty-two patients with ankle osteoarthritis admitted to Luoyang Orthopedic-Traumatological Hospital of Henan Province from January 2020 to January 2023 were retrospectively selected.And they were divided into the anterior group(42 cases,treated by ankle arthrodesis with plate fixation through the anterior approach)and the lateral group(40 cases,treated by ankle arthrodesis with plate fixation through the lateral approach)according to the surgical approach.The incision length,operation duration,postoperative drainage volume,fracture healing time,American Association of Foot and Ankle society(AOFAS)score,postoperative talus tilt angle and calcaneal angle,serum prostaglandin E2(PGE2)level,substance P level and incidence of complications were compared between the two groups.ResultsThe incision length,operation duration and fracture healing time in the anterior group were shorter than those in the lateral group(P<0.05).There was no significant difference in postoperative drainage volume between the two groups(P>0.05).After surgery,the levels of PGE2 and substance P in the two groups were lower than those before operation,while the levels of PGE2 and substance P in the anterior group were lower than those in the lateral group(P<0.05).Before operation,there was no significant difference in AOFAS score of ankle function between the two groups(P>0.05).The AOFAS score of ankle function in the two groups showed an upward trend at 3,6 and 12 months after operation(P<0.05).There were statistically significant differences in time-varying comparison,inter-group comparison and interactive comparison of AOFAS(P<0.05).After operation,the talus tilt angle and calcaneal angle in the two groups were higher than those before operation,and the anterior group had higher talus tilt angle and calcaneal angle than the lateral group(P<0.05).There was no serious co

关 键 词：踝关节骨性关节炎 踝关节融合术 钢板内固定 手术入路 

分 类 号：R687.4[医药卫生—骨科学]