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创伤性踝关节炎:人工踝关节置换术与踝关节融合术的早期疗效对比

, PP. 2391-2396

Keywords: 创伤性关节炎,踝关节融合,踝关节置换,疗效

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Abstract:

目的对在创伤性踝关节炎的手术治疗中,传统的踝关节融合术与踝关节置换术这两种手术方式的早期疗效进行对比研究。方法回顾性研究收集自2009年3月-2014年10月在我院因创伤性踝关节炎行手术治疗的患者55例(56踝),平均年龄为51.2岁,平均随访35.3(3~68)个月。分别将采用人工全踝关节置换术、踝关节融合外支架固定术、踝关节融合内固定术的患者分为3组,其中行人工踝关节置换术的患者14例(14踝),平均随访35.4(7~67)个月;行踝关节融合外支架固定术的患者18例(19踝),平均随访31.2(3~68)个月;行踝关节融合内固定组的患者23例(23踝),平均随访38.8(10~58)个月;对3组患者分别在术前、术后使用美国骨科足踝协会后足评分(AOFAS)、SF-36评分、关节活动度(ROM)进行分析评价,对术后并发症进行统计分析,比较踝关节置换术与融合术的早期疗效。结果55例患者均获得随访,踝关节置换术组术后AOFAS评分为72.92±5.42,SF-36评分为79.42±4.23,踝关节融合组(外支架固定)术后AOFAS评分为69.36±3.21,SF-36评分为67.78±4.51,踝关节融合(内固定)术后AOFAS评分为67.41±6.49,SF-36评分为72.86±6.37,3组均较术前评分有明显改善(P<0.05),且踝关节置换组在术后各评分较融合组高,踝关节置换组术后踝关节活动度为(32.1±4.7)°较术前明显改善。随访3组并发症的发生分别为2例、4例(外固定组)、3例(内固定组),早期并发症发生率差异没有统计学意义(P>0.05)。结论在创伤性关节炎的手术治疗中,人工踝关节置换术较踝关节融合术在早期内对病患的生活质量改善更明显,没有增加相应的术后并发症。

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