Ilizarov外固定架在终末期复杂性踝关节炎融合术中的应用

杨永强; 符长红; 李福兵; 姚玲; 万值颖; 李军

Ilizarov外固定架在终末期复杂性踝关节炎融合术中的应用

1. 昆明医科大学
2. 解放军昆明总医院骨科

基金项目:

基金：国家自然科学基金资助项目 (81171734);

计量
- 文章访问数: 1753
- HTML全文浏览量: 593
- PDF下载量: 70
- 被引次数: 0
出版历程
- 收稿日期: 2017-04-10

Application of Ilizarov External Fixator in the Arthrodesis of End-stage Complex Ankle Arthritis

Funds:

基金：国家自然科学基金资助项目 (81171734);

摘要

摘要: 目的对Ilizarov环形外固定架在终末期复杂性踝关节炎融合术中的临床效果进行分析.方法选取2013年1月至2014年5月, 于解放军昆明总医院收的治终末期复杂性踝关节病损患者 (n=19) 为研究对象, 行Ilizarov外固定架踝关节融合术, 术后定期复查X线片.分别于术前及末次随访采用视觉模拟评分 (VAS) 评价、美国矫形足踝协会 (AOFAS) 的踝与后足评分.结果 19例患者术后获得830个月 (平均14.7个月) 随访, 术中患者均未发生重要血管、神经损伤.末次随访时踝部疼痛明显缓解、畸形得到改善, X线提示所有患者均获得完全融合, 融合时间1116个周, 平均14.7周.术前静息、负重VAS评分平均分别为4.9分、7.9分, 术后分别为1.2分、1.9分, 差异有统计学意义 (P<0.001) .AOFAS术前评分 (58.74±4.00) 分, 术后末次随访为 (93.21±4.47) 分, 差异有统计学意义 (P<0.001) .结论 Ilizarov环形外固定架在终末期复杂性踝关节炎融合术中疗效满意, 具有持续提供轴向压应力, 软组织创伤小, 融合率高的优势.
- 踝关节炎 /
- 踝关节融合 /
- Ilizarow外固定架
Abstract: Objective To analyze the clinical effects of Ilizarov external fixation in arthrodesis on patients with end-stage complex ankle arthritis. Methods From January 2013 to May 2014, 19 patients with end-stage complicated ankle arthritis in our hospital underwent ankle arthrodesis with Ilizarov external fixation. X-ray were conducted regularly after the operation. Clinical outcomes were evaluated by using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the Visual Analogue Scale (VAS) in pre-operation and the last follow-up. T-test was applied to analyze data. Results The 19 patients obtained an average follow-up of14.7 months (ranging from 6 to 25 months) , no injury to key vascular and nerves during operation. Ankle pain was obviously relieved, and deformity was improved significantly at the last follow-up. All patients achieved full arthrodesis according to the X-ray results after 11 to 16 weeks (average of 14.7 weeks) . In the Visual Analogue Scale, preoperative resting state was scored 4.9 and the weight state was 7.9, which were significantly reduced to 1.2 and 1.9 respectively after operation (P=0.000) . In AOFAS ankle-hindfoot score, the pre-operative score was 58.74±4.00, which significantly increased to 93.21±4.47 in the last follow-up (P=0.000) . Conclusions Ilizarov external fixator is effective in the arthrodesis of end-stage complex ankle arthritis. And its advantage shows in axial compression, smaller soft tissue injury, and higher fusion rate.
- Ankle arthritis /
- Ankle arthrodesis /
- Ilizarov external fixation

HTML全文

参考文献(18)

[1]王军伟, 王虎, 赵凯, 等.经腓骨截骨并植骨踝关节融合术治疗终末期踝部关节炎[J].中国骨与关节损伤杂志, 2014, 29 (2) :193-194.
[2]	[2]KITAOKA H B, ALEXANDER I J, ADELAAR R S, et al.Clinical rating systems for the ankle-hindfoot, midfot, hallux and lesser toes[J].Foot Ankle International, 1994, 15 (7) :349-353.
[3]	[3]RAIKIN S M, RASOULI M R, ESPANDAR R, et al.Trends in treatment of advanced ankle arthropathy by total ankle replacement or ankle fusion.[J].Foot&Ankle International, 2014, 35 (3) :216-224.
[4]	[4]SALTZMAN C L, KADOKO R G, JIN S S.Treatment of Isolated Ankle Osteoarthritis with Arthrodesis or the Total Ankle Replacement:A Comparison of Early tcomes[J].Clinics in Orthopedic Surgery, 2010, 2 (1) :1-7.
[5]	[5]SALTZMAN C L, MANN R A, AHRENS J E, et al.Prospective controlled trial of STAR total ankle replacement versus ankle fusion:initial results.[J].Foot&Ankle International, 2009, 30 (7) :579-596.
[6]张涛, 庞桂根, 马宝通, 等.踝关节融合的治疗进展[J].中国矫形外科杂志, 2012, 20 (18) :1681-1683.
[7] 卢世璧.坎贝尔骨科手术学[M].第9版.济南:山东科学技术出版社, 2003:143-164.
[8]	[8]MOHAMEDEAN A, SAID H G, ELSHARKAWI M, et al.Technique and short-term results of ankle arthrodesis using anterior plating.[J].International Orthopaedics, 2010, 34 (6) :833-837.
[9]葛建华, 张德绸, 陈歌, 等.踝关节融合3种内固定方法的疗效分析[J].现代预防医学, 2011, 38 (10) :1967-1969.
[10]杨云峰, 俞光荣, 梅炯, 等.踝关节固定对后足运动的影响[J].同济大学学报 (医学版) , 2005, 26 (1) :78-81.
[11]	[11]AHMAD J, POUR A E, RAIKIN S M.The modified use of a proximal humeral locking plate for tibiotalocalcaneal Arthrodesis.[J].Foot&Ankle International, 2007, 28 (9) :977-983.
[12]	[12]TARKIN I S, MORMINO M A, CLARE M P, et al.Anterior plate supplementation increases ankle arthrodesis construct rigidity.[J].Foot&Ankle International, 2007, 28 (2) :219-223.
[13]	[13]KAKARALA G, RAJAN D T.Comparative study of ankle arthrodesis using cross screw fixation versus anterior contoured plate plus cross screw fixation.[J].Acta Orthopaedica Belgica, 2006, 72 (6) :716-721.
[14]	[14]BAUMHAUER J F, MCINTOSH S, RECHTINE G.Age and sex differences between patient and physician-derived outcome measures in the foot and ankle.[J].Journal of Bone&Joint Surgery, 2013, 95 (3) :209-214.
[15]	[15]HUNT K J, ELLINGTON J K, ANDERSON R B, et al.Locked versus nonlocked plate fixation for hallux MTP arthrodesis.[J].Foot&Ankle International, 2011, 32 (7) :704-709.
[16]	[16]KRISTEN, KARLHEINZ, TRNKA, et al.Ankle Arthrodesis With an Anterior Approach[J].Techniques in Foot&Ankle Surgery, 2007, 6 (6) :243-248.
[17]	[17]KITAOKA H B, ANDERSON P J, MORREY B F.Revision of ankle arthrodesis with external fixation for non-union.[J].Journal of Bone&Joint Surgery, 1992, 74 (8) :1191-2000.
[18]	[18]KREGOR P J, STANNARD J, ZLOWODZKI M, et al.Distal femoral fracture fixation utilizing the Less Invasive Stabilization System (L.I.S.S.) :the technique and early results.[J].Injury-international Journal of the Care of the Injured, 2001, 32 (3) :32-47.

相关文章(20)

[1]	陈一晗, 张善勇, 丁昱, 张莉. 颞下颌关节骨关节炎分子致病机制的研究进展, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20240701
[2]	董卓谦, 刘盾, 邵水艳, 陈兴康, 单吉升, 陈涛. 踝关节损伤康复治疗中Physio Space平衡板运动控制训练的疗效观察, 昆明医科大学学报.
[3]	皇甫文丽, 黄瑶, 刘波, 吕长海, 刘娟, 代自超. 建立大鼠颞下颌关节骨关节炎动物模型的2种方法比较, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230308
[4]	杜钰娟, 陈华英, 田晓芳, 李玉婷, 姚静雯, 赵明月, 张丽芬. 类风湿关节炎患者出院准备度现状及影响因素, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220603
[5]	张菁, 王汇淞, 王磊. 自主突破康复法对复杂踝关节骨折脱位患者术后康复效果、恢复期生活质量的影响, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20211121
[6]	刘路平, 朱兰然, 张卫, 陈磊杰, 王超然, 廖经武. 2种不同手术方法治疗陈旧性踝关节骨折合并下胫腓联合损伤的对比, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20211017
[7]	易南星, 梁倩倩, 张伟强, 施杞, 王拥军, 徐浩, 张霆. 骨性关节炎相关滑膜炎症研究进展, 昆明医科大学学报.
[8]	闫慧玲, 赵宏斌, 钱传云, 王应忠, 张洋, 沈相霖, 蒋罡, 高爽. 膝骨关节炎疗效评估的研究进展, 昆明医科大学学报.
[9]	王涛, 张伟强, 艾元亮, 唐晓霞, 郭英, 李帆冰. 膝骨性关节炎病程与患侧踇外翻的相关性, 昆明医科大学学报.
[10]	陆元元, 龙婷, 冯蕾, 刘维超, 李国晖, 吴雷. 痛风气雾剂治疗急性痛风性关节炎的用药综合护理, 昆明医科大学学报.
[11]	李龙滕, 李彦林, 王坤, 肖渝, 闫祥甲. 信号通路在骨性关节炎发病中的作用, 昆明医科大学学报.
[12]	杨再英. 骨质疏松症对骨性关节炎发病机制的影响, 昆明医科大学学报.
[13]	代龙金. β-连环蛋白与膝骨关节炎相关性研究, 昆明医科大学学报.
[14]	邓鹏鹏. 玻璃酸钠治疗膝关节骨性关节炎的系统评价, 昆明医科大学学报.
[15]	杨洋. 保守治疗老年女性膝关节骨性关节炎的护理体会, 昆明医科大学学报.
[16]	谢筱晞. 3.0T磁共振成像评价踝关节运动损伤的应用价值, 昆明医科大学学报.
[17]	. 高血脂类风湿关节炎动脉粥样硬化患者超声分析, 昆明医科大学学报.
[18]	. ADAMTS-4在膝骨关节炎关节液中的表达和意义, 昆明医科大学学报.
[19]	王伟. 骨关节炎患者软骨细胞的体外培养技术, 昆明医科大学学报.
[20]	丁晶. 踝关节周围血管网的应用解剖学研究, 昆明医科大学学报.