CAJ | 학술논문

目的观察踝关节胫骨滑槽植骨融合术治疗大骨节病晚期临床疗效.方法选择33例大骨节病晚期患者,行踝关节融合术,其中双踝手术5例,单纯右踝手术13例,左踝手术15例.术中采用胫骨滑槽植骨空心螺钉内固定,术后石膏外固定.随访0.5～6.0年,比较术前及末次随访美国矫形外科足踝协会(AOFAS)评分以判定疗效,X线片评估术后融合情况.结果 33例均未发生切口感染、血管神经损伤等严重并发症.末次随访时,30例无明显不适,3例踝关节轻度疼痛及轻度肿胀,长时间行走或站立后足跟部有轻度酸胀感,并未影响日常生活.AOFAS评分由术前的(25.84±16.81)分,提高至术后的(87.32±4.68)分,差异有统计学意义(P＜0.01).临床疗效优25例,良5例,可2例,差1例.33例患者术后骨性融合率100％(33/33).结论采用踝关节胫骨滑槽植骨融合术治疗大骨节病晚期患者,操作简单、植骨融合率高、并发症少,疗效值得肯定.
목적 관찰과관절경골활조식골융합술치료대골절병만기림상료효.방법 선택33례대골절병만기환자,행과관절융합술,기중쌍과수술5례,단순우과수술13례,좌과수술15례.술중채용경골활조식골공심라정내고정,술후석고외고정.수방0.5～6.0년,비교술전급말차수방미국교형외과족과협회(AOFAS)평분이판정료효,X선편평고술후융합정황.결과 33례균미발생절구감염、혈관신경손상등엄중병발증.말차수방시,30례무명현불괄,3례과관절경도동통급경도종창,장시간행주혹참립후족근부유경도산창감,병미영향일상생활.AOFAS평분유술전적(25.84±16.81)분,제고지술후적(87.32±4.68)분,차이유통계학의의(P＜0.01).림상료효우25례,량5례,가2례,차1례.33례환자술후골성융합솔100％(33/33).결론 채용과관절경골활조식골융합술치료대골절병만기환자,조작간단、식골융합솔고、병발증소,료효치득긍정.
Objective To observe the clinical curative effect of ankle chute tibia bone graft fusion treatment of late kaschin-beck disease.Methods Thirty-three patients with late kaschin-beek disease performed ankle arthrodesis,the ankle surgery in 5 cases,simple right ankle surgery in 13 eases and 15 cases of left ankle surgery.Intraoperative used tibial chute hollow screw internal fixation and bone graft plaster external fixation postoperatively.Followed up 0.5-6.0 years,compared the American orthopaedic food and ankle society (AOFAS) score before surgery to determine the efficacy of last follow-up,X ray film fusion situation assessment in the postoperative period.Results Thirty-three cases did not occur postoperative incision infection,vascular or nerve complications.Last follow-up,30 cases were no obvious discomfort,3 cases of mild ankle pain,accompanied by walking or standing for a long time after the foot heel had mild acid bilges feeling,did not affect the daily life.The AOFAS score before surgery was significantly lower than that last follow-up [(25.84 ± 16.81) scores vs.(87.32 ± 4.68) scores] (P ＜ 0.01).Clinical efficacy excellent in 25 cases,good in 5 cases,general in 2 cases,poor in 1 case.Follow-up X line piece was showed that in all cases to achieve bony fusion.Conclusion Using sliding kashin-beck terminal patients treated ankle bone graft fusion,simple operation,high bone graft fusion rate,less complications,curative effect is positive.