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-  2017 

Ilizarov 外固定行踝关节融合治疗晚期创伤性踝关节炎疗效分析

DOI: doi:10.7507/1002-1892.201702010

Keywords: Ilizarov 外固定, 踝关节融合, 创伤性踝关节炎

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Abstract:

目的 评估 Ilizarov 外固定技术行踝关节融合治疗晚期创伤性踝关节炎的临床效果。 方法 2013 年 6 月—2015 年 6 月采用 Ilizarov 外固定技术治疗晚期创伤性踝关节炎患者 27 例。男 16 例,女 11 例;年龄 27~69 岁,平均 45.7 岁。左侧 16 例,右侧 11 例。患者均为首次外伤导致踝关节骨折或韧带损伤,经 6 个月以上规范保守治疗无效,且踝关节疼痛、活动障碍。病程为 3~39 年,平均 11.5 年。根据 Takakura 踝关节炎分期,3 期 16 例,4 期 11 例。术前摄双足站立正侧位 X 线片测量胫距角为(102.55±4.02)°。术前美国矫形足踝协会(AOFAS)足与踝关节评分为(45.72±6.45)分,疼痛视觉模拟评分(VAS)为(8.61±1.96)分。 结果 27 例患者均获随访,随访时间 15~42 个月,平均 28.1 个月。踝关节均达骨性融合,融合时间 11~18 周,平均 12.9 周。随访期间未出现切口及针道区域持续性出血。出现轻度针道感染 4 例,距骨前脱位 2 例,不同程度踝关节活动受限 3 例;未见创伤性骨缺损、骨不连、假关节形成等并发症。术后 12 个月 AOFAS 评分、VAS 评分、胫距角分别为(80.53±9.14)分、(2.77±0.82)分、(94.36±2.48)°,均较术前显著改善(t=16.17,P=0.00;t=14.28,P=0.00;t=9.01,P=0.00)。临床疗效评价为优 9 例、良 13 例、可 5 例,优良率 81.5%。 结论 Ilizarov 外固定行踝关节融合治疗晚期创伤性踝关节炎可获得满意疗效,远期疗效仍需大样本随机对照试验进一步证实

References

[1]  1. Santos AL, Demange MK, Prado MP, et al. Cartilage lesions and ankle osteoarthrosis: review of the literature and treatment algorithm. Rev Bras Ortop, 2014, 49(6): 565-572.
[2]  3. Takakura Y, Tanaka Y, Kumai T, et al. Low tibial osteotomy for osteoarthritis of the ankle. Results of a new operation in 18 patients. J Bone Joint Surg (Br), 1995, 77(1): 50-54.
[3]  11. Thordarson DB, Markolf K, Cracchiolo A 3rd. Stability of an ankle arthrodesis fixed by cancellous-bone screws compared with that fixed by an external fixator. A biomechanical study. J Bone Joint Surg (Am), 1992, 74(7): 1050-1055.
[4]  13. 焦绍锋, 秦泗河, 王振军, 等. Ilizarov 技术治疗四肢畸形并发症分析. 中华骨科杂志, 2012, 32(3): 245-248.
[5]  15. Kugan R, Aslam N, Bose D, et al. Outcome of arthrodesis of the hindfoot as a salvage procedure for complex ankle pathology using the Ilizarov technique. Bone Joint J, 2013, 95-B(3): 371-377.
[6]  16. Salem KH, Kinzl L, Schmelz A. Ankle arthrodesis using Ilizarov ring fixators: a review of 22 cases. Foot Ankle Int, 2006, 27(10): 764-770.
[7]  17. Illgner U, Budny T, Frohne I, et al. Clinical benefit and improvement of activity level after reconstruction surgery of Charcot feet using external fixation: 24-months results of 292 feet. BMC Musculoskelet Disord, 2014, 15: 392.
[8]  18. Laporta GA, Nasser EM, Mulhern JL. Tibiocalcaneal arthrodesis in the high-risk foot. J Foot Ankle Surg, 2014, 53(6): 774-786.
[9]  19. Malizos KN, Gougoulias NE, Dailiana ZH, et al. Relapsed clubfoot correction with soft-tissue release and selective application of Ilizarov technique. Strategies Trauma Limb Reconstr, 2008, 3(3): 109-117.
[10]  20. Schuh R, Hofstaetter J, Krismer M, et al. Total ankle arthroplasty versus ankle arthrodesis. Comparison of sports, recreational activities and functional outcome. Int Orthop, 2012, 36(6): 1207-1214.
[11]  21. McCoy TH, Goldman V, Fragomen AT, et al. Circular external fixator-assisted ankle arthrodesis following failed total ankle arthroplasty. Foot Ankle Int, 2012, 33(11): 947-955.
[12]  22. Labek G, Thaler M, Janda W, et al. Revision rates after total joint replacement: cumulative results from worldwide joint register datasets. J Bone Joint Surg (Br), 2011, 93(3): 293-297.
[13]  2. Rabinovich RV. Complex ankle arthrodesis: Review of the literature. World J Orthop, 2015, 6(8): 602-613.
[14]  4. 段小军, 尹力, 杨柳, 等. 关节镜辅助踝关节融合术治疗晚期创伤性踝关节炎. 中华骨科杂志, 2013, 33(4): 403-408.
[15]  5. 赵宏谋, 俞光荣, 杨云峰. 踝关节骨性关节炎的治疗现状. 中华关节外科杂志 (电子版), 2009, 3(1): 86-89.
[16]  6. Ploegmakers JJ, van Roermund PM, van Melkebeek J, et al. Prolonged clinical benefit from joint distraction in the treatment of ankle osteoarthritis. Osteoarthritis Cartilage, 2005, 13(7): 582-588.
[17]  7. Fragomen AT, Borst E, Schachter L, et al. Complex ankle arthrodesis using the Ilizarov method yields high rate of fusion. Clin Orthop Relat Res, 2012, 470(10): 2864-2873.
[18]  8. Ramos T, Ekholm C, Eriksson BI, et al. The Ilizarov external fixator—a useful alternative for the treatment of proximal tibial fractures. A prospective observational study of 30 consecutive patients. BMC Musculoskelet Disord, 2013, 14: 11.
[19]  9. Rodriguez-Collazo ER, Urso ML. Combined use of the Ilizarov method, concentrated bone marrow aspirate (cBMA), and platelet-rich plasma (PRP) to expedite healing of bimalleolar fractures. Strategies Trauma Limb Reconstr, 2015, 10(3): 161-166.
[20]  10. Tellisi N, Fragomen AT, Ilizarov S, et al. Limb salvage reconstruction of the ankle with fusion and simultaneous tibial lengthening using the Ilizarov/Taylor spatial frame. HSS J, 2008, 4(1): 32-42.
[21]  12. Hoover JR, Santrock RD, James WC 3rd. Ankle fusion stability: a biomechanical comparison of external versus internal fixation. Orthopedics, 2011, 34(4). doi: 10.3928/01477447-20110228-04.
[22]  14. Rozbruch SR. Posttraumatic reconstruction of the ankle using the Ilizarov method. HSS J, 2005, 1(1): 68-88.

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