CAJ | 학술논문

目的观察自行研制的渐进性U型低温矫形器矫治创伤性足下垂畸形的效果. 方法回顾性分析2011年4月至2014年5月35例胫骨行环式外固定支架固定术后因伤创等因素并发足下垂畸形且应用自行研制的渐进性U型低温矫形器进行矫治的患者资料,男28例,女7例;年龄16～65岁,平均34.0岁;右侧16例,左侧19例.矫治前均有轻至中度的垂足畸形,佩戴渐进性U型低温矫形器进行矫治.通过比较足踝矫治前、矫治后6个月及末次随访时背屈、跖屈、内翻、外翻的角度及视觉模拟评分(VAS)观察矫治效果.结果 28患者术后获10 ～ 25个月(平均16.1个月)随访.末次随访时的背屈、跖屈、内翻、外翻的角度和VAS评分与矫治前比较,差异均有统计学意义(P＜0.05).末次随访时的背屈、跖屈、外翻的角度和VAS评分与矫治后6个月比较,差异均有统计学意义(P＜0.05).矫治后6个月的背屈、外翻的角度和VAS评分与矫治前比较,差异均有统计学意义(P＜0.05).3例患者因损伤严重、年龄、依从性差等因素矫治效果不明显.28例患者中均无出现压疮、血管神经损伤和严重的足下垂畸形并发症. 结论自行研制的渐进性U型低温矫形器矫治胫骨环式外固定支架术后出现的足下垂畸形,是个安全、行之有效的方法.
목적 관찰자행연제적점진성U형저온교형기교치창상성족하수기형적효과. 방법 회고성분석2011년4월지2014년5월35례경골행배식외고정지가고정술후인상창등인소병발족하수기형차응용자행연제적점진성U형저온교형기진행교치적환자자료,남28례,녀7례;년령16～65세,평균34.0세;우측16례,좌측19례.교치전균유경지중도적수족기형,패대점진성U형저온교형기진행교치.통과비교족과교치전、교치후6개월급말차수방시배굴、척굴、내번、외번적각도급시각모의평분(VAS)관찰교치효과.결과 28환자술후획10 ～ 25개월(평균16.1개월)수방.말차수방시적배굴、척굴、내번、외번적각도화VAS평분여교치전비교,차이균유통계학의의(P＜0.05).말차수방시적배굴、척굴、외번적각도화VAS평분여교치후6개월비교,차이균유통계학의의(P＜0.05).교치후6개월적배굴、외번적각도화VAS평분여교치전비교,차이균유통계학의의(P＜0.05).3례환자인손상엄중、년령、의종성차등인소교치효과불명현.28례환자중균무출현압창、혈관신경손상화엄중적족하수기형병발증. 결론 자행연제적점진성U형저온교형기교치경골배식외고정지가술후출현적족하수기형,시개안전、행지유효적방법.
Objective To evaluate our self-developed static U-shape orthosis which stretches progressively in a low temperature for treatment of posttraumatic equinus contracture in patients who underwent tibial ring external fixation.Methods From April 2011 to May 2014,a ring external fixator was used to treat 35 patients with tibial bone defect,infectious nonunion or osteomyelitis.They were 28 males and 7 females,aged from 16 to 65 years (average,34.0 years).The left side was affected in 16 and the right side in 19 cases.There were 27 open tibial fractures and 8 closed tibial fractures with postoperative infection.Their mild to moderate posttraumatic equinus contracture was corrected with our static U-shape orthosis which stretched progressively in a low temperature.The efficacy was evaluated by comparing dorsal flexion,plantar flexion,varus and valgus of the ankle and the visual analogue scale (VAS) scores before correction,6 months after correction,and at the last follow-up.Results The 28 patients were followed up for 10 to 25 months (average,16.1 months) postoperation.The dorsal flexion,plantar flexion,varus and valgus of the ankle and the VAS scores at the last follow-up were significantly improved compared with those before correction (P ＜ 0.05).The dorsal flexion,plantar flexion,varus and valgus of the ankle and the VAS scores at the last follow-up were also significantly improved compared with those at 6 months after correction (P ＜ 0.05).The dorsal flexion,plantar flexion,varus and valgus of the ankle and the VAS scores at 6 months after correction were also significantly improved compared with those before correction (P ＜ 0.05).Three cases did not respond well to the correction due to injury severity,age,or poor compliance.There were no reports of numbness or skin problems.Conclusions Our self-developed static U-shape orthosis which stretches progressively in a low temperature has proved to be a safe and effective ancillary correction of the posttraumatic equinus contracture in patients undergoing tibial ring external fixation.