發(fā)布時(shí)間：2018-04-20 02:31

  本文選題：骨贅清理術(shù) + Ilizarov技術(shù)　； 參考：《中國矯形外科雜志》2017年04期

【摘要】：[目的]探討骨贅清理結(jié)合Ilizarov關(guān)節(jié)牽伸術(shù)治療中晚期踝關(guān)節(jié)炎的臨床療效。[方法]回顧性分析2009年10月~2014年12月本科收治的9例中晚期踝關(guān)節(jié)炎的病例,女6例,男3例;年齡20~45歲,平均34.2歲。均為單側(cè)發(fā)病。踝關(guān)節(jié)創(chuàng)傷病史5例,脊髓灰質(zhì)炎后遺癥足部矯形術(shù)后病史3例,無足部相關(guān)疾病史者1例。采用切開清除踝關(guān)節(jié)骨贅,然后安裝術(shù)前已組裝好的Ilizarov踝關(guān)節(jié)牽伸外固定器,術(shù)后逐漸牽伸并維持踝關(guān)節(jié)間隙5~8 mm負(fù)重行走。采用AOFAS踝-后足評(píng)分評(píng)價(jià)臨床療效。[結(jié)果]9例患者獲得隨訪,末次隨訪時(shí)間為術(shù)后12~60個(gè)月,平均29.4個(gè)月。術(shù)后佩戴外固定器時(shí)間12~24周,平均16周。末次隨訪時(shí)AOFAS踝-后足評(píng)分76~89分,平均(81±7.2)分,較術(shù)前29~48分,平均(34.6±4.9)分,差異有統(tǒng)計(jì)學(xué)意義。未出現(xiàn)嚴(yán)重并發(fā)癥。5例隨訪過程中出現(xiàn)輕中度外固定針道感染,給予局部酒精敷料包扎結(jié)合口服抗生素后控制。1例足跟固定針折斷,未予特殊處理,拆除外固定裝置時(shí)拔除。[結(jié)論]骨贅清理術(shù)結(jié)合Ilizarov關(guān)節(jié)牽伸術(shù)治療中晚期踝關(guān)節(jié)炎是一種簡單有效的方法,創(chuàng)傷小,能延緩關(guān)節(jié)置換或踝關(guān)節(jié)融合時(shí)間。
[Abstract]:Objective: to investigate the clinical effect of osteophyte debridement combined with Ilizarov joint drafting in the treatment of middle and late ankle arthritis. [methods] from October 2009 to December 2014, 9 cases of middle and late ankle arthritis were retrospectively analyzed, including 6 females and 3 males, aged 2045 years with an average of 34.2 years. All of them were unilateral. There were 5 cases of ankle trauma, 3 cases of poliomyelitis sequelae after orthopedic foot surgery, and 1 case of no history of foot related diseases. The osteophyte of ankle joint was removed by incision, and then the external fixator of Ilizarov was installed before operation. After the operation, the ankle joint space was gradually stretched and the ankle space was maintained with 58 mm weight-bearing walking. AOFAS ankle-hind foot score was used to evaluate the clinical efficacy. [results] Nine patients were followed up, the last follow-up time was 12 ~ 60 months (mean 29.4 months). The time of wearing external fixator was 12 ~ 24 weeks (mean 16 weeks). At the last follow-up, the AOFAS ankle-hind foot score was 7689, with an average score of 81 鹵7.2, which was significantly higher than the preoperative score of 29 ~ 48 and the mean score of 34.6 鹵4.9). There were no serious complications in 5 cases with mild and moderate infection of external fixation needle. After local alcohol dressing combined with oral antibiotics, 1 cases of heel fixation needle fracture were controlled, without special treatment, when the external fixator was removed, the external fixation device was removed. [conclusion] osteophyte debridement combined with Ilizarov arthrodesis is a simple and effective method for the treatment of middle and advanced ankle arthritis. It has less trauma and can delay the time of arthroplasty or ankle joint fusion.
【作者單位】： 北京市垂楊柳醫(yī)院矯形骨科;國家康復(fù)輔具中心附屬康復(fù)醫(yī)院矯形骨科;
【基金】：首都臨床特色應(yīng)用研究課題(編號(hào):Z141107002514038)
【分類號(hào)】：R687.4

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本文編號(hào)：1775868