中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2015年
6期
461-464
,共4页
赵良军%劳山%赵劲民%薄占东%花奇凯%罗高斌
趙良軍%勞山%趙勁民%薄佔東%花奇凱%囉高斌
조량군%로산%조경민%박점동%화기개%라고빈
舟骨%骨缺血坏死%成人%外科手术
舟骨%骨缺血壞死%成人%外科手術
주골%골결혈배사%성인%외과수술
Scaphoid bone%Avascular necrosis of bone%Adult%Surgical procedures,operative
目的 探讨手术治疗成人足舟骨缺血性坏死的手术方式和疗效. 方法 对2008年12月至2013年12月采用舟骨关节植骨融合内固定手术治疗的9例成人舟骨缺血性坏死患者的临床资料进行回顾性分析,男2例,女7例;年龄32 ～ 60岁,平均42岁;按Maceira分期:Ⅱ期1例,Ⅲ期4例,Ⅳ期3例,Ⅴ期1例;6例行距舟-舟楔关节融合术,2例行单纯距舟关节融合术,1例行三关节融合术.结果 9例患者术后获12 ～ 18个月(平均15.8个月)随访,患足疼痛及间歇性跛行等症状消失,患足均获骨性融合,融合时间12 ～ 17周(平均14.6周);术后1年美国足踝外科协会的踝-后足评分为80分,其中优1例,良7例,可1例.术后1年患足的足长度[(15.5±0.8) cm]、足弓高度[(18.6±0.9) mm]、内侧纵弓顶角(119.2°±6.4°)分别与术前[(14.3±0.9) cm、(10.2±0.7) mm、136.5°±7.8°]比较,差异均有统计学意义(P＜0.05). 结论 对于成人足舟骨缺血性坏死的治疗,根据术前及术中评估舟骨及相关联的关节病变累及程度选择合适的手术方式,可以取得满意疗效.
目的 探討手術治療成人足舟骨缺血性壞死的手術方式和療效. 方法 對2008年12月至2013年12月採用舟骨關節植骨融閤內固定手術治療的9例成人舟骨缺血性壞死患者的臨床資料進行迴顧性分析,男2例,女7例;年齡32 ～ 60歲,平均42歲;按Maceira分期:Ⅱ期1例,Ⅲ期4例,Ⅳ期3例,Ⅴ期1例;6例行距舟-舟楔關節融閤術,2例行單純距舟關節融閤術,1例行三關節融閤術.結果 9例患者術後穫12 ～ 18箇月(平均15.8箇月)隨訪,患足疼痛及間歇性跛行等癥狀消失,患足均穫骨性融閤,融閤時間12 ～ 17週(平均14.6週);術後1年美國足踝外科協會的踝-後足評分為80分,其中優1例,良7例,可1例.術後1年患足的足長度[(15.5±0.8) cm]、足弓高度[(18.6±0.9) mm]、內側縱弓頂角(119.2°±6.4°)分彆與術前[(14.3±0.9) cm、(10.2±0.7) mm、136.5°±7.8°]比較,差異均有統計學意義(P＜0.05). 結論 對于成人足舟骨缺血性壞死的治療,根據術前及術中評估舟骨及相關聯的關節病變纍及程度選擇閤適的手術方式,可以取得滿意療效.
목적 탐토수술치료성인족주골결혈성배사적수술방식화료효. 방법 대2008년12월지2013년12월채용주골관절식골융합내고정수술치료적9례성인주골결혈성배사환자적림상자료진행회고성분석,남2례,녀7례;년령32 ～ 60세,평균42세;안Maceira분기:Ⅱ기1례,Ⅲ기4례,Ⅳ기3례,Ⅴ기1례;6례행거주-주설관절융합술,2례행단순거주관절융합술,1례행삼관절융합술.결과 9례환자술후획12 ～ 18개월(평균15.8개월)수방,환족동통급간헐성파행등증상소실,환족균획골성융합,융합시간12 ～ 17주(평균14.6주);술후1년미국족과외과협회적과-후족평분위80분,기중우1례,량7례,가1례.술후1년환족적족장도[(15.5±0.8) cm]、족궁고도[(18.6±0.9) mm]、내측종궁정각(119.2°±6.4°)분별여술전[(14.3±0.9) cm、(10.2±0.7) mm、136.5°±7.8°]비교,차이균유통계학의의(P＜0.05). 결론 대우성인족주골결혈성배사적치료,근거술전급술중평고주골급상관련적관절병변루급정도선택합괄적수술방식,가이취득만의료효.
Objective To evaluate surgical treatment of Müller-Weiss disease.Methods From December 2008 to December 2013,9 cases of Müller-Weiss disease were treated at our department with arthrodesis of the scaphoid joint and internal fixation.They were 2 males and 7 females,32 to 60 years of age (average,42 years).According to the Maceira classification,there were one case of phase 2,4 cases of phase 3,3 cases of phase 4,and one case of phase 5.Six cases received arthrodesis of the talo-naviculo-cuneiform joints,2 cases arthrodesis of the talonavicular joint and one case triple arthrodesis.Results The 9 patients were followed up for 12 to 18 months (average,15.8 months).Pain and intermittent claudication disappeared in all the patients.The bony fusion was achieved in all the affected feet after 12 to 17 months (average,14.6 months).The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores at one year post-surgery averaged 80 points.One foot was excellent,7 feet were good,and the other foot was fair.At one year post-surgery,the foot length (15.5 ±0.8 cm),arch height (18.6 ± 0.9 mm),and medial longitudinal foot arch (119.2° ± 6.4°) were significantly improved compared with those before surgery (14.3±0.9cm,10.2±0.7mmand 136.5°±7.8°,respectively) (P ＜0.05).Conclusion Surgical treatment of Müller-Weiss disease,according to preoperative and intraoperative evaluations of the scaphoid bone and related injury,may achieve satisfactory outcomes.
