| 关节内截骨治疗伴有内侧穹隆顶骨缺损的内翻型踝关节炎的疗效分析 |
| Clinical outcome of intra-articular osteotomy in treatment of varus ankle arthritis accompanied by medial distal tibial plafond defects |
| 投稿时间：2024-02-20 |
| DOI：10.3969/j.issn.1672-5972.2024.04.009 |
| 中文关键词: 骨关节炎 踝关节 截骨术 |
| 英文关键词:Osteoarthritis Ankle joint Osteotomy |
| 基金项目: |
|
| 摘要点击次数: 34 |
| 全文下载次数: 72 |
| 中文摘要: |
| 目的 探讨关节内截骨治疗伴有内侧穹隆顶骨缺损的内翻型踝关节炎的临床疗效。方法 回顾分析2012年1月至2021年1月中国人民解放军北部战区总医院采用关节内截骨治疗的16例伴有内侧穹隆顶骨缺损的内翻型踝关节炎患者的临床资料。其中，男12例，女4例，平均年龄48.3岁（39 ～ 65岁）。根据Takakura分期：Ⅱ期5例，Ⅲa期8例，Ⅲb期3例。记录术后并发症、骨愈合时间及内固定失效情况，比较踝关节屈伸活动度及影像学指标变化，包括胫骨前方关节面角（tibial anterior surface angle, TAS）、胫骨侧方关节面角（tibial lateral surface angle, TLS）、距骨倾斜角（talar tilt angle, TT）及踝穴角（tibiocrural angle, TC），并采用Takakura踝关节评分和美国足踝外科协会（American Orthopedic Foot and Ankle Society, AOFAS）踝与后足功能评分评价临床疗效。结果 16例患者均获得术后随访，平均随访时间为33.8个月（12 ～ 60个月）。2例术后切口延迟愈合，无血管、神经及肌腱损伤发生。16例患者均获骨愈合，平均愈合时间4.4个月（3 ～ 6个月）。2例因骨关节炎加重或畸形复发行踝关节融合术。末次随访时无内固定失效发生。患者末次随访的TT低于术前、TC高于术前，差异有统计学意义（P＜0.05）；末次随访的TAS、TLS和踝关节屈伸活动度与术前比较，差异无统计学意义（P＞0.05）。患者的末次随访的Takakura踝关节评分、AOFAS评分高于术前，差异有统计学意义（P＜0.05）。结论 对于伴有内侧穹隆顶骨缺损的内翻型踝关节炎患者，关节内截骨可以有效缓解疼痛、改善关节功能，临床疗效满意。 |
| 英文摘要: |
| Objective To review the clinical outcome of intra-articular osteotomy for varus ankle arthritis associated with medial distal tibial plafond defects.Methods Clinical data of 16 patients with varus ankle arthritis accompanied by medial distal tibial plafond defects who were treated with intra-articular osteotomy from January 2012 to January 2021 at Northern Theater General Hospital were respectively analyzed. There were 12 males and 4 females, with a mean age of 48.3 years (range, 39-65 years). According to Takakura classification, there were 5 cases in stage Ⅱ, 8 cases in stage Ⅲa and 3 cases in stage Ⅲb. Postoperative complications, bone healing time and failure of internal fixation were recorded. The range of motion of ankle joint, tibial anterior surface angle (TAS), tibial lateral surface angle (TLS), talar tilt angle (TT), and tibiocrural angle (TC) were evaluated. Clinical efficacy was evaluated according to Takakura Ankle Evaluation Rating Scale and the American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale.Results All 16 cases were followed up for average 33.8 months (range, 12-60 months). Delayed healing of incision occurred in 2 cases. There were no neurovascular or tendon injuries. All patients got bony union with a mean time of 4.4 months (range, 3-6 months). Two patients underwent ankle arthrodesis due to worsening or recurrence of osteoarthritis. There were no failures of internal fixation at the last follow-up. TT was lower than that before surgery, and the TC was higher than that before surgery, with statistically significant differences (P<0.05). There was no statistically significant difference in TAS, TLS, and ankle range of motion (P>0.05). The Takakura ankle score and the AOFAS score were significantly improved compared with the preoperative values (P<0.05).Conclusion In varus ankle arthritis associated with medial-distal tibial plafond defects, intra-articular osteotomy can effectively relieve pain and improve joint function with a satisfactory clinical outcome. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
