经腓骨截骨入路髓内钉胫距跟融合术对终末期踝关节炎患者的治疗效果分析OA
Analysis of the Therapeutic Outcmones of Intramedullary Nail Tibiotalocalcaneal Arthrodesis via a Fibular Osteotomy Approach in Patients with End-Stage Ankle Arthritis
目的:探讨经腓骨截骨入路髓内钉胫距跟融合术对终末期踝关节炎患者的治疗效果.方法:回顾性分析 2018年 1 月—2021年 12月佛山市中医院收治的 41例终末期踝关节炎患者资料.所有患者均术后随访复查 3年.比较患者临床指标、疼痛程度、踝关节功能、影像学结果及并发症发生情况.结果:41例患者手术时间平均(80.51±9.85)min,术中出血量平均(150.17±15.22)mL.术后 6个月、3 年,患者疼痛视觉模拟法评分均低于术前,美国骨科足踝外科协会踝-后足评分量表评分均高于术前,差异均有统计学意义(P<0.05).术后 3年,患者冠状位胫跟角大于术前,差异有统计学意义(P<0.05);矢状位胫跟角与术前相比,差异无统计学意义(P>0.05).术后 3个月,骨性愈合 11例,愈合率 26.83%;术后6个月,骨性愈合 40例,愈合率 97.56%;术后 1年,骨性愈合 41例,愈合率 100%.随访期间,并发症发生率为 9.76%.结论:采用经腓骨截骨入路髓内钉胫距跟融合术对终末期踝关节炎患者进行治疗,可有效提高患者融合率、缓解疼痛、促进踝关节功能恢复,矫正并维持后足力线.
Objective:To investigate the therapeutic effect of intramedullary nail tibiotalocalcaneal arthrodesis via a transfibular osteotomy approach in patients with end-stage ankle arthritis.Methods:A retrospective analysis was conducted on 41 the data of patients with end-stage ankle arthritis admitted to Foshan Hospital of Traditional Chinese Medicine from January 2018 to December 2021.All the patients were postoperative follow-up and reexamination for 3 years.The clinical indicators,pain degree,ankle function,imaging results and complications were compared.Results:The average operation time of the 41 patients was(80.51±9.85)min,and the average intraoperative blood loss was(150.17±15.22)mL.At 6 months and 3 years after surgery,the Pain Visual Analogue Score of the patients was lower than tpreoperative values,and the scores of the American Orthopaedic Foot and Ankle Society,Ankle-Hindfoot Rating Scale were higher than those before surgery,the differences were statistically significant(P<0.05).Three years after operation,the tibial calcaneal angle was larger than that before operation,the differences was statistically significant(P<0.05),and there was no significant difference between the sagittal tibial calcaneal angle and that before operation(P>0.05).At 3 years postoperatively,the coronal tibiocalcaneal angle was greater than that preoperatively,with a statistically significant difference(P<0.05);by contrast,the sagittal tibiocalcaneal angle showed no statistically significant difference compared with preoperative values(P>0.05).Three months postoperatively,bony union was achieved in 11 cases,resulting in a healing rate of 26.83%;six months postoperatively,40 cases of bony union were achieved,with a healing rate of 97.56%;one year postoperatively,41 cases of bony union were achieved,reaching a healing rate of 100%.The overall complication rate during the follow-up period was 9.76%.Conclusion:Tibiotalocalcaneal arthrodesis using an intramedullary nail system via a fibular osteotomy approach is a safe,effective,and stable treatment option for end-stage ankle arthritis,with a high fusion rate,significant hindfoot alignment correction.
赖志斌;杨康勇;沈国栋;程郴
广州中医药大学第八临床医学院,广东 佛山 528000||广东省佛山市中医院足踝外科,广东 佛山 528000广州中医药大学第八临床医学院,广东 佛山 528000||广东省佛山市中医院足踝外科,广东 佛山 528000广州中医药大学第八临床医学院,广东 佛山 528000||广东省佛山市中医院足踝外科,广东 佛山 528000广州中医药大学第八临床医学院,广东 佛山 528000||广东省佛山市中医院足踝外科,广东 佛山 528000
医药卫生
终末期踝关节炎胫距跟融合术髓内钉经腓骨截骨入路
End-Stage ankle arthritisTibiotalocalcaneal arthrodesisIntramedullary nailTransfibular osteotomy approach
《中国伤残医学》 2025 (10)
24-27,4
佛山市卫生健康局医学科研课题立项(20220118).
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