CAJ | 학술논문

目的探讨Müller-Weiss病的手术治疗和疗效.方法 2005年3月至2011年5月,对15例(15足)Müller-Weiss病的患者进行手术治疗,男性2例,女性13例；年龄26～62岁,平均51.8岁.术前美国足踝医师协会(AOFAS)踝-后足评分为(42±13)分.根据Maceira分期,2期1例,3期6例,4期4例,5期4例.根据术前评估,采用的手术方法有应用接骨板行距舟楔关节融合术、应用接骨板行距舟关节融合和舟楔关节固定术、应用螺钉行三关节融合术.结果应用接骨板行距舟楔关节融合术10例,应用接骨板行距舟关节融合和舟楔关节固定术3例,应用螺钉行三关节融合术2例.13例患者获得9 ～38个月随访,平均19.2个月.所有患足都获得融合,融合时间为12 ～16周,平均13.3周.末次随访AOFAS踝-后足评分为(83±6)分,优2例、良10例、可1例.足长度术前为(14.2±1.O) cm,末次随访时为(15.7±0.9)cm(t =11.570,P＜0.05)；Meary角术前为-6.1°±13.1°,末次随访时为1.1°±3.0°(t=2.248,P＜0.05)；距跟角术前为4.5°±2.2°,末次随访时为18.0°±4.0°(t=11.700,P＜0.05).所有患者术后均未发生切口感染,舟楔关节固定处接骨板和螺钉断裂1例.结论对Müller-Weiss病进行手术治疗,根据具体情况采用不同的治疗方案,可以取得满意疗效.
목적 탐토Müller-Weiss병적수술치료화료효.방법 2005년3월지2011년5월,대15례(15족)Müller-Weiss병적환자진행수술치료,남성2례,녀성13례；년령26～62세,평균51.8세.술전미국족과의사협회(AOFAS)과-후족평분위(42±13)분.근거Maceira분기,2기1례,3기6례,4기4례,5기4례.근거술전평고,채용적수술방법유응용접골판행거주설관절융합술、응용접골판행거주관절융합화주설관절고정술、응용라정행삼관절융합술.결과 응용접골판행거주설관절융합술10례,응용접골판행거주관절융합화주설관절고정술3례,응용라정행삼관절융합술2례.13례환자획득9 ～38개월수방,평균19.2개월.소유환족도획득융합,융합시간위12 ～16주,평균13.3주.말차수방AOFAS과-후족평분위(83±6)분,우2례、량10례、가1례.족장도술전위(14.2±1.O) cm,말차수방시위(15.7±0.9)cm(t =11.570,P＜0.05)；Meary각술전위-6.1°±13.1°,말차수방시위1.1°±3.0°(t=2.248,P＜0.05)；거근각술전위4.5°±2.2°,말차수방시위18.0°±4.0°(t=11.700,P＜0.05).소유환자술후균미발생절구감염,주설관절고정처접골판화라정단렬1례.결론 대Müller-Weiss병진행수술치료,근거구체정황채용불동적치료방안,가이취득만의료효.
Objective To discuss operative methods and effects for Müller-Weiss disease.Methods From March 2005 to May 2011,15 patients were operated. There were 2 males and 13 females,with an average age of 51.8 years (range,26 to 62 years).The preoperative American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score was (42 ± 13)points. According to the Maceira Staging system,1 foot was grade 2,6 feet were grade 3,4 feet were grade 4,and 4 feet were grade 5. The technique consisted of arthrodesis of the talonaviculocuneiform joints with plate,arthrodesis of the talonavicular joint and arthrorisis of naviculocuneiform joint with plate,or triple arthrodesis with screws,according to the preoperative evaluation.Results Ten feet were treated with arthrodesis of the talonaviculocuneiform joints,3 feet were treated with arthrodesis of the talonavicular joint and arthrorisis of naviculocuneiform joint and 2 feet were treated with triple arthrodesis.Two patients were lost to follow-up.The average follow-up after operation was 19.2 months (range,9 to 38 months).All feet were solid fusion and the average duration of union was 13.3 weeks (range,12-16 weeks).The AOFAS ankle-hindfoot score at the last follow-up was (83±6) points.Two feet were excellent,10 feet were good,and 1 foot was fair.The length of feet was ( 14.2 ± 1.0) cm before surgery and ( 15.7 ± 0.9) cm at the last follow-up ( t =11.570,P ＜ 0.05 ).The Meary's angle was -6.1° ± 13.1°before surgery and 1.1° ±± 3.0°at the last follow-up (t =2.248,P ＜0.05 ).The talocalcaneal angle was 4.5 ° ± 2.2 ° before surgery and 18.0 ° ± 4.0° at the last follow-up ( t =11.700,P ＜0.05).One foot had breakage of the plate and screws at arthrorisis of naviculocuneiform joint and none had complications related to the incision. Conclusion Operations for Müller-Weiss disease,according to concrete conditions using different therapeutic program,may achieve a satisfactory outcome.