CAJ | 학술논문

目的探讨前路双钢板行踝关节融合术的近期疗效.方法自2009年9月至2011年10月采用前路双钢板行踝关节融合术治疗踝关节严重病损患者15例,男10例,女5例；年龄22 ～59岁,平均39.2岁.创伤性关节炎9例,骨关节炎3例,类风湿性关节炎3例.通过比较术前与末次随访时美国足踝外科协会(AOFAS)踝-后足评分评定疗效,术后根据踝关节X线检查观察融合情况. 结果所有患者术后获9～18个月(平均13个月)随访.末次随访时全部踝关节均已骨性融合,融合时间9 ～ 28周,平均14周.AOFAS踝-后足评分由术前(36.1±8.1)分提高至末次随访时(82.7±6.3)分,差异有统计学意义(t=23.961,p=0.000).所有患者切口均I期愈合,无感染、局部皮肤坏死等并发症发生.至末次随访未出现螺钉、钢板松动、断裂等现象. 结论利用踝关节前路双锁定钢板行踝关节融合术适用于病变严重、骨质缺损较多的患者,短期疗效确切.
목적 탐토전로쌍강판행과관절융합술적근기료효.방법 자2009년9월지2011년10월채용전로쌍강판행과관절융합술치료과관절엄중병손환자15례,남10례,녀5례；년령22 ～59세,평균39.2세.창상성관절염9례,골관절염3례,류풍습성관절염3례.통과비교술전여말차수방시미국족과외과협회(AOFAS)과-후족평분평정료효,술후근거과관절X선검사관찰융합정황. 결과 소유환자술후획9～18개월(평균13개월)수방.말차수방시전부과관절균이골성융합,융합시간9 ～ 28주,평균14주.AOFAS과-후족평분유술전(36.1±8.1)분제고지말차수방시(82.7±6.3)분,차이유통계학의의(t=23.961,p=0.000).소유환자절구균I기유합,무감염、국부피부배사등병발증발생.지말차수방미출현라정、강판송동、단렬등현상. 결론 이용과관절전로쌍쇄정강판행과관절융합술괄용우병변엄중、골질결손교다적환자,단기료효학절.
Objective To report short-term outcomes of ankle arthrodesis using anterior double plating system.Methods From September 2009 to October 2011,15 patients with end-stage arthritis of the ankle were treated by ankle arthrodesis with anterior double plating system in our department.They were 10 males and 5 females,aged from 22 to 59 years (average,39.2 years).Nine cases were post-traumatic arthritis,3 osteoarthritis and 3 rheumatoid arthritis.The ankle function was assessed preoperation and at the last follow-up in all patients according to the ankle and hindfoot scoring of American Orthopaedic Foot and Ankle Society (AOFAS); bone union was assessed by radiographs.Results The follow-up periods for the 15 patients lasted from 9 to 18 months (average,13 months).Bone union was obtained in all at the last follow-up.The fusion time ranged from 9 to 28 weeks (average,14 weeks).The mean AOFAS score increased significantly from preoperative 36.1 ± 8.1 points to 82.7 ± 6.3 points at the last follow-up (t =23.961,P =0.000).All the 15 patients achieved primary healing of incision and were free of complications like infection or local skin necrosis.No implant failure was observed at the last follow-up.Conclusions The anterior double plating system is an effective method to achieve solid ankle arthrodesis,with advantages of clear operative field,simplicity,rigid fixation and high fusion rate.Its short-term efficacy is definite particularly in patients with severe bone defect or loss of bone stock.