Ilizarov外固定架在终末期复杂性踝关节炎融合术中的应用
Application of Ilizarov External Fixator in the Arthrodesis of End-stage Complex Ankle Arthritis
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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.
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关键词:
- 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.-
Key words:
- Ankle arthritis /
- Ankle arthrodesis /
- Ilizarov external fixation
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