中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2010年
12期
1068-1072
,共5页
谭晓康%唐康来%周兵华%曹洪辉%徐格%周建波%李辉%谢美明%陶旭%许建中
譚曉康%唐康來%週兵華%曹洪輝%徐格%週建波%李輝%謝美明%陶旭%許建中
담효강%당강래%주병화%조홍휘%서격%주건파%리휘%사미명%도욱%허건중
距下关节%关节镜检查%踝损伤%关节炎
距下關節%關節鏡檢查%踝損傷%關節炎
거하관절%관절경검사%과손상%관절염
Subtalar joint%Arthroscopy%Ankle injuries%Arthritis
目的 探讨关节镜下经皮穿针空心螺钉内固定融合治疗距下关节创伤性关节炎的方法并评价其临床疗效.方法 选择2006年4月-2009年12月收治的12例严重距下关节创伤性关节炎患者,其中男5例,女7例;年龄28～68岁,平均45.6岁.均为单纯距下关节病变,经保守治疗、疼痛控制无效,选择关节镜下经皮穿针空心螺钉内固定的距下关节融合术.患者术前、术后均采用美国足踝外科协会(America Orthopedic Foot and Ankle Society,AOFAS)踝-后足功能评分表进行临床随访,同时,采用X线摄片进行影像学评估.结果 术后平均随访21.2个月(6～48个月).12例患者AOFAS术前评分(54.67±5.28)分(43～61分),术后末次随访评分(89.17±3.56)分(78～95分),优良率为93%.术后X线片显示,11例距下关节骨性融合,平均融合时间为12.4周(9～15周).1例出现骨不连,行走后外踝下方疼痛,给予石膏靴固定制动3个月后复查X线片,距下关节骨性融合.结论 关节镜下经皮穿针空心螺钉内固定融合治疗距下关节创伤性关节炎可获得良好的临床疗效,是一种值得推荐的手术方法.
目的 探討關節鏡下經皮穿針空心螺釘內固定融閤治療距下關節創傷性關節炎的方法併評價其臨床療效.方法 選擇2006年4月-2009年12月收治的12例嚴重距下關節創傷性關節炎患者,其中男5例,女7例;年齡28～68歲,平均45.6歲.均為單純距下關節病變,經保守治療、疼痛控製無效,選擇關節鏡下經皮穿針空心螺釘內固定的距下關節融閤術.患者術前、術後均採用美國足踝外科協會(America Orthopedic Foot and Ankle Society,AOFAS)踝-後足功能評分錶進行臨床隨訪,同時,採用X線攝片進行影像學評估.結果 術後平均隨訪21.2箇月(6～48箇月).12例患者AOFAS術前評分(54.67±5.28)分(43～61分),術後末次隨訪評分(89.17±3.56)分(78～95分),優良率為93%.術後X線片顯示,11例距下關節骨性融閤,平均融閤時間為12.4週(9～15週).1例齣現骨不連,行走後外踝下方疼痛,給予石膏靴固定製動3箇月後複查X線片,距下關節骨性融閤.結論 關節鏡下經皮穿針空心螺釘內固定融閤治療距下關節創傷性關節炎可穫得良好的臨床療效,是一種值得推薦的手術方法.
목적 탐토관절경하경피천침공심라정내고정융합치료거하관절창상성관절염적방법병평개기림상료효.방법 선택2006년4월-2009년12월수치적12례엄중거하관절창상성관절염환자,기중남5례,녀7례;년령28～68세,평균45.6세.균위단순거하관절병변,경보수치료、동통공제무효,선택관절경하경피천침공심라정내고정적거하관절융합술.환자술전、술후균채용미국족과외과협회(America Orthopedic Foot and Ankle Society,AOFAS)과-후족공능평분표진행림상수방,동시,채용X선섭편진행영상학평고.결과 술후평균수방21.2개월(6～48개월).12례환자AOFAS술전평분(54.67±5.28)분(43～61분),술후말차수방평분(89.17±3.56)분(78～95분),우량솔위93%.술후X선편현시,11례거하관절골성융합,평균융합시간위12.4주(9～15주).1례출현골불련,행주후외과하방동통,급여석고화고정제동3개월후복사X선편,거하관절골성융합.결론 관절경하경피천침공심라정내고정융합치료거하관절창상성관절염가획득량호적림상료효,시일충치득추천적수술방법.
Objective To investigate the clinical outcome of arthroscopic percutaneous cannulated screw fixation with subtalar fusion in the treatment of post-traumatic subtalar arthritis. Methods The study involved 12 patients (five males and seven females) with severe post-traumatic subtalar arthritis admitted to our hospital from April 2006 to December 2009. The patients were at age range of 28-68 years ( mean 45.6 years). All patients had the history of conservative treatment but failed in pain alleviation.Then, the percutaneous cannulated screw fixation plus subtalar fusion was selected. The ande and hind foot of all patients were evaluated preoperatively and postoperatively by the American Orthopedic Foot and Ankle Society (AOFAS) scoring system. Imaging assessment was carried out by X-ray examination.Results The patients were followed up for mean 21.2 months (range 6-48 months), which showed thatthe mean AOFAS ankle-hindfoot scale was increased from (54.67 ± 5.28 ) points (range 43-61 points)preoperatively to (89.17 ±3.56) points (range 78-95 points) at final follow-up, with excellence rate of 93%. Eleven patients got good fusion with the mean time of 12.4 weeks (range 9-15 weeks). Only one patient had nonunion, with the pain in the lateral malleolus. The subtalar joint of the patient got union after plaster immobilization for three months, which was proved by X-ray examination. Conclusions The arthroscopic percutaneous cannulated screw fixation and subtalar fusion can acquire good clinical outcomes and hence is a recommended procedure for post-traumatic subtalar arthritis.
