發(fā)布時(shí)間：2018-05-20 21:54

  本文選題：踝關(guān)節(jié) + 關(guān)節(jié)病�。� 參考：《華北理工大學(xué)》2017年碩士論文

【摘要】：目的研究討論關(guān)節(jié)鏡下踝關(guān)節(jié)融合術(shù)治療踝關(guān)節(jié)骨關(guān)節(jié)病的療效價(jià)值。方法選取自2012年1月至2016年3月之間的23例(23踝)踝關(guān)節(jié)骨關(guān)節(jié)病患者,對(duì)其進(jìn)行關(guān)節(jié)鏡下踝關(guān)節(jié)融合術(shù)以治療踝關(guān)節(jié)骨關(guān)節(jié)病。其中14例為創(chuàng)傷性關(guān)節(jié)炎,6例為骨性關(guān)節(jié)炎,3例為類風(fēng)濕性關(guān)節(jié)炎,男13例,女10例。術(shù)前均排除臨近關(guān)節(jié)病變或者其他導(dǎo)致下肢畸形的骨骼疾患,年齡分布在47歲~65歲范圍,平均58歲。術(shù)前AOFAS功能評(píng)分平均26.91分。常規(guī)對(duì)所有患者行手術(shù)前后的負(fù)重位雙踝關(guān)節(jié)正側(cè)位X線片檢查,并且確保所有患者投照條件均保持統(tǒng)一標(biāo)準(zhǔn),術(shù)前在踝關(guān)節(jié)X線影像上觀看臨近關(guān)節(jié)是否存在病變,并進(jìn)行手術(shù)前的設(shè)計(jì)。手術(shù)均采用關(guān)節(jié)鏡下踝關(guān)節(jié)融合術(shù),在關(guān)節(jié)鏡下處理關(guān)節(jié)面的軟骨及軟骨下骨,處理完畢后維持踝關(guān)節(jié)于功能位,應(yīng)用空心加壓螺釘進(jìn)行堅(jiān)強(qiáng)的固定�；颊咝g(shù)后均保持隨訪,時(shí)間平均為15月,在此期間密切觀察患者術(shù)后情況、患側(cè)踝關(guān)節(jié)狀態(tài)變化以及骨性融合情況。結(jié)果對(duì)所有患者進(jìn)行了平均長(zhǎng)達(dá)15個(gè)月的隨訪,結(jié)果顯示每位患者的踝關(guān)節(jié)都達(dá)到骨性融合標(biāo)準(zhǔn)。雖然術(shù)后患者踝關(guān)節(jié)活動(dòng)度降低,但患者踝關(guān)節(jié)腫痛癥狀明顯減輕或消失,術(shù)后患側(cè)踝關(guān)節(jié)AOFAS功能評(píng)分明顯提高,平均高達(dá)86.08分,患者生活質(zhì)量明顯得到提高。結(jié)論關(guān)節(jié)鏡下踝關(guān)節(jié)融合術(shù)治療踝關(guān)節(jié)骨關(guān)節(jié)病操作簡(jiǎn)單,術(shù)中創(chuàng)傷小,不破壞踝周組織結(jié)構(gòu),融合率高,術(shù)后恢復(fù)快、并發(fā)癥少,早期效果良好,患者獲得穩(wěn)定、無(wú)痛的踝關(guān)節(jié),能夠從事部分體力勞動(dòng),是踝關(guān)節(jié)融合的理想方法。
[Abstract]:Objective to study the effect of arthroscopic ankle arthrodesis on ankle osteoarthropathy. Methods from January 2012 to March 2016, 23 patients with ankle osteoarthropathy were treated with arthroscopic ankle arthrodesis. Among them, 14 cases were traumatic arthritis, 6 cases were osteoarthritis, 3 cases were rheumatoid arthritis, 13 cases were males and 10 cases were females. All patients were excluded from adjacent articular lesions or other bone diseases leading to deformities of lower extremities. The age ranged from 47 to 65 years (mean 58 years). Preoperative AOFAS score averaged 26.91. Before and after operation, all patients were routinely examined with radiographs on the front and side sides of the bilateral ankle joints in the loading position, and to ensure that the radiographic conditions of all the patients remained uniform, and to observe whether there were lesions in the adjacent joints on the X-ray images of the ankle joints before and after the operation. The design before operation was carried out. Arthroscopic treatment of articular cartilage and subchondral bone were used to maintain the functional position of the ankle joint and the hollow compression screw was used for strong fixation. All the patients were followed up for an average of 15 months. During this period, the condition of the patients, the status of the affected ankle and the condition of bone fusion were closely observed. Results all patients were followed up for an average of 15 months. Although the motion of ankle joint decreased after operation, the symptoms of swelling and pain of ankle were obviously alleviated or disappeared. The score of AOFAS function of the affected side of ankle was obviously improved after operation, and the average score was up to 86.08, and the quality of life of the patients was obviously improved. Conclusion arthroscopic arthrodesis for the treatment of ankle osteoarthropathy is simple, with less trauma, no destruction of perimalleolar tissue structure, high fusion rate, rapid postoperative recovery, less complications, good early effect and stable patients. Painless ankle joint, able to engage in part of physical labor, ankle fusion is the ideal method.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.4

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