CAJ | 학술논문

目的探讨对严重距下关节炎患者采用经皮穿针反向平行植入空心螺钉行距下关节融合的临床疗效.方法自2008年4月至2012年4月,对保守治疗6个月以上无效的严重距下关节炎88例患者(90足)行距下关节融合治疗,男56例,女32例,平均年龄43.7(15 ～74)岁,手术选择4种不同切口.术前、术后都采用AOFAS踝-后足评分和VAS评分,摄距下关节正、斜位及跟骨轴位X线或CT,评价距下关节融合情况.结果 68例患者得到平均18.5(6 ～48)个月有效随访,X线片或CT显示67例患者已骨性融合,其中1例患者出现骨不愈合,融合率为98.5％,平均融合时间13.8(6 ～28)周,术前与末次随访时VAS评分由6.00分下降至1.03分,差异有统计学意义(P＜0.05).术前与末次随访时AOFAS分由57.0分增至80.6分,差异有统计学意义(P＜0.05),优良率为80.8％.结论经皮穿针反向平行植入空心螺钉行距下关节融合术具有融合率高、恢复快、并发症少,易于推广等优点.
목적 탐토대엄중거하관절염환자채용경피천침반향평행식입공심라정행거하관절융합적림상료효.방법 자2008년4월지2012년4월,대보수치료6개월이상무효적엄중거하관절염88례환자(90족)행거하관절융합치료,남56례,녀32례,평균년령43.7(15 ～74)세,수술선택4충불동절구.술전、술후도채용AOFAS과-후족평분화VAS평분,섭거하관절정、사위급근골축위X선혹CT,평개거하관절융합정황.결과 68례환자득도평균18.5(6 ～48)개월유효수방,X선편혹CT현시67례환자이골성융합,기중1례환자출현골불유합,융합솔위98.5％,평균융합시간13.8(6 ～28)주,술전여말차수방시VAS평분유6.00분하강지1.03분,차이유통계학의의(P＜0.05).술전여말차수방시AOFAS분유57.0분증지80.6분,차이유통계학의의(P＜0.05),우량솔위80.8％.결론 경피천침반향평행식입공심라정행거하관절융합술구유융합솔고、회복쾌、병발증소,역우추엄등우점.
Objective To explore the clinical efficacy of subtalar joint arthrodesis with percutaneous opposite parallel cannulated screws for severe subtalar joint arthritis.Methods A total of 88 patients with 90 feet underwent subtalar joint fusion under four different incisions from April 2008 to April 2012.There were 56 males and 32 females with a mean age of 43.7 (15-74) years.All of them were evaluated by radiography or computed tomography (CT) scan and assessed by the rating scores of visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS).Results Among them,68 cases were followed up for an average of 18.5 (6-48) months.Fusion was confirmed on radiography or CT in 67 cases with a fusion rate of 98.5％.The mean duration of fusion was 13.8 (6-28) weeks,the mean VAS score decreased from 6.00 to 1.03 points (P ＜ 0.05) and the mean AOFAS score improved from 57.0 to 80.6 points (P ＜ 0.05) with a good-and-excellent rate of 80.8％.Conclusion Subtalar joint arthrodesis with percutaneous opposite parallel cannulated screws is recommend for severe subtalar joint arthritis.Such a procedure has a high fusion rate,excellent clinical outcomes and fewer complications.