中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2011年
2期
135-139
,共5页
谢鸣%方真华%赵晶晶%陈明%郑琼%勘武生
謝鳴%方真華%趙晶晶%陳明%鄭瓊%勘武生
사명%방진화%조정정%진명%정경%감무생
跟骨%骨折%关节融合术%外固定器
跟骨%骨摺%關節融閤術%外固定器
근골%골절%관절융합술%외고정기
Calcaneus%Fractures%Arthrodesis%External fixators
目的 评价llizarov外固定支架治疗StephenⅢ型陈旧性跟骨骨折畸形愈合的疗效。方法 自2006年7月至2009年2月,采用一期距下关节融合、跟骨截骨并Ilizarov外固定支架牵伸二期纠正畸形治疗StephenⅢ型陈旧性跟骨骨折畸形愈合患者25例,男19例,女6例;年龄19 ~49岁,平均32岁;左足15例,右足10例。既往累计手术次数1~5次,平均2次。术后应用美国足踝外科协会(AOFAS)踝与后足评分系统进行评价。结果 所有患者术后获18.3个月(6~36个月)随访。治疗结束时所有患者内、外翻畸形均得到完全或大部分矫正,可以用足底行走负重。距下关节均一期融合,跟骨高度、宽度、长度、B(o)hler角及Gissane角均得到明显恢复。81%的患者取得内、外翻畸形的解剖复位或近解剖复位。AOFAS评分平均为79.4分,优2例,良18例,一般4例,差1例,优良率为80.0%。所有关节融合的部位最后均获得骨连接,无一例患者发生内、外翻畸形需再次手术。结论 对于StephenⅢ型陈旧性跟骨骨折畸形愈合患者,采用一期距下关节融合、跟骨截骨并Ilizarov外固定支架缓慢牵伸纠正畸形可获得良好疗效。
目的 評價llizarov外固定支架治療StephenⅢ型陳舊性跟骨骨摺畸形愈閤的療效。方法 自2006年7月至2009年2月,採用一期距下關節融閤、跟骨截骨併Ilizarov外固定支架牽伸二期糾正畸形治療StephenⅢ型陳舊性跟骨骨摺畸形愈閤患者25例,男19例,女6例;年齡19 ~49歲,平均32歲;左足15例,右足10例。既往纍計手術次數1~5次,平均2次。術後應用美國足踝外科協會(AOFAS)踝與後足評分繫統進行評價。結果 所有患者術後穫18.3箇月(6~36箇月)隨訪。治療結束時所有患者內、外翻畸形均得到完全或大部分矯正,可以用足底行走負重。距下關節均一期融閤,跟骨高度、寬度、長度、B(o)hler角及Gissane角均得到明顯恢複。81%的患者取得內、外翻畸形的解剖複位或近解剖複位。AOFAS評分平均為79.4分,優2例,良18例,一般4例,差1例,優良率為80.0%。所有關節融閤的部位最後均穫得骨連接,無一例患者髮生內、外翻畸形需再次手術。結論 對于StephenⅢ型陳舊性跟骨骨摺畸形愈閤患者,採用一期距下關節融閤、跟骨截骨併Ilizarov外固定支架緩慢牽伸糾正畸形可穫得良好療效。
목적 평개llizarov외고정지가치료StephenⅢ형진구성근골골절기형유합적료효。방법 자2006년7월지2009년2월,채용일기거하관절융합、근골절골병Ilizarov외고정지가견신이기규정기형치료StephenⅢ형진구성근골골절기형유합환자25례,남19례,녀6례;년령19 ~49세,평균32세;좌족15례,우족10례。기왕루계수술차수1~5차,평균2차。술후응용미국족과외과협회(AOFAS)과여후족평분계통진행평개。결과 소유환자술후획18.3개월(6~36개월)수방。치료결속시소유환자내、외번기형균득도완전혹대부분교정,가이용족저행주부중。거하관절균일기융합,근골고도、관도、장도、B(o)hler각급Gissane각균득도명현회복。81%적환자취득내、외번기형적해부복위혹근해부복위。AOFAS평분평균위79.4분,우2례,량18례,일반4례,차1례,우량솔위80.0%。소유관절융합적부위최후균획득골련접,무일례환자발생내、외번기형수재차수술。결론 대우StephenⅢ형진구성근골골절기형유합환자,채용일기거하관절융합、근골절골병Ilizarov외고정지가완만견신규정기형가획득량호료효。
Objective To evaluate the clinical effects of Ilizarov external fixator for maluninon of obsolete calcaneal fracture of Stephen Type Ⅲ.Methods From July 2006 to February 2009, 25 patients suffering from maluninon of obsolete calcaneal fracture of Stephen Type 1 were treated with subtalar arthrodesis and calcaneal osteotomy followed by fixation with Ilizarov external fixator. They were 19 men and 6women, aged from 19 to 49 years. Fifteen left feet and 10 right feet were involved. The patients underwent previous operations from one to 5 times, averaging twice. The postoperative functions were evaluated by American Orthopaedic Foot & Ankle Society (AOFAS) scoring system.Results The average follow-up was 18.3 months (from 6 to 36 months). 81% of the patients obtained anatomic or nearly anatomic reduction of the varus and valgus. The average AOFAS score was 79.4, with 2 excellent, 18 good, 4 fair and one poor cases.ConclusionSubtalar arthrodesis and calcaneal osteotomy followed by fixation with Ilizarov external fixator is effective for treating maluninon of obsolete calcaneal fracture of Stephen Type Ⅲ.