【摘要】：目的探討應(yīng)用Ilizarov技術(shù)行脛跟或脛距跟融合同期治療踝關(guān)節(jié)感染并骨缺損的效果。方法 2014年1月—2016年4月,應(yīng)用Ilizarov技術(shù)行脛跟或脛距跟融合同期治療踝關(guān)節(jié)感染并骨缺損14例。其中男12例,女2例;年齡25~61歲,平均39.8歲。踝關(guān)節(jié)感染原因:外傷12例,其中高處墜落傷5例,摔傷4例,交通事故傷1例,砸傷1例,扭傷1例;血源性2例。入院前曾行手術(shù)0~8次,平均3.7次。術(shù)前改良美國矯形足踝協(xié)會(huì)(AOFAS)踝與后足評(píng)分為(30.25±3.54)分。病程1~30個(gè)月,平均10.3個(gè)月。結(jié)果患者術(shù)后切口均Ⅰ期愈合,無感染復(fù)發(fā),均未行二期植骨融合等手術(shù)干預(yù)。1例患者訴行走時(shí)間30 min后出現(xiàn)踝關(guān)節(jié)周圍輕度疼痛及腫脹,未行特殊處理;患者術(shù)后出現(xiàn)0~3次不同程度針眼紅腫情況,經(jīng)相應(yīng)處理后緩解。14例均獲隨訪,隨訪時(shí)間6~27個(gè)月,平均16.8個(gè)月。除2例尚未拆除外固定架(帶架時(shí)間分別為6、8個(gè)月),其余患者均于術(shù)后6~14個(gè)月,平均9個(gè)月拆除外固定架,均恢復(fù)行走功能。拆架后改良AOFAS踝與后足評(píng)分為(70.92±1.05)分,與術(shù)前比較差異有統(tǒng)計(jì)學(xué)意義(t= 10.992,P=0.000)。結(jié)論結(jié)合Ilizarov技術(shù)行脛跟或脛距跟融合同期治療踝關(guān)節(jié)感染并骨缺損是一種簡(jiǎn)便有效的治療方法。
[Abstract]:Objective to investigate the effect of tibial heel or tibial heel fusion with Ilizarov in the treatment of ankle infection and bone defect. Methods from January 2014 to April 2016, 14 patients with ankle infection and bone defect were treated with tibial heel or tibial heel fusion with Ilizarov technique. There were 12 males and 2 females with an average age of 39.8 years (2561 years). The causes of ankle infection were 12 cases of trauma, 5 cases of falling injury, 4 cases of falling injury, 1 case of traffic accident, 1 case of smashing injury, 1 case of sprain, and 2 cases of blood source. Eight operations were performed before admission, with an average of 3.7. The preoperative (AOFAS) and hind foot scores of the modified American Association of Orthopaedic ankles were (30.25 鹵3.54). The course of disease ranged from 1 to 30 months with an average of 10.3 months. Results all the incisions healed in the first stage, no infection recurred, and no secondary bone grafting and fusion were performed. One patient complained of mild pain and swelling around the ankle after 30 min of walking time, without special treatment. There were 3 times of different degree of needle-eye redness after operation, which was relieved by corresponding treatment. 14 cases were followed up for 6-27 months (mean 16.8 months). Except for 2 patients who had not removed the external fixator (6 months and 8 months respectively), the other patients were removed from 6 to 14 months after operation, and the external fixator was removed for an average of 9 months, and the walking function was restored. The scores of modified AOFAS ankle and hind foot were (70.92 鹵1.05), which were significantly different from those before operation (t = 10.992 鹵0.000). Conclusion tibial heel or tibial heel fusion combined with Ilizarov technique is a simple and effective method for the treatment of ankle infection associated with bone defect.
【作者單位】： 河南省洛陽正骨醫(yī)院河南省骨科醫(yī)院骨髓炎一科;河南科技大學(xué)第二附屬醫(yī)院VIP科;
【分類號(hào)】：R687.3

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