带外翻角的逆行髓内钉行胫距跟关节融合术治疗后足畸形
方真华;胡家朗;赵晶晶;陈明;郑琼;任义军;勘武生
【期刊名称】《中华创伤骨科杂志》 【年(卷),期】2016(018)009
【摘要】目的 探讨使用带外翻角的逆行髓内钉行胫距跟关节融合术治疗后足畸形的疗效.方法 回顾性分析2009年6月至2014年1月接受带外翻角的逆行髓内钉行胫距跟关节融合术治疗且获得完整随访的22例后足畸形患者资料,男12例,女10例;年龄46 ～ 79岁,平均62.2岁;其中原发踝关节骨关节炎3例,创伤性关节炎9例,严重距骨缺血性坏死继发踝关节炎1例,踝关节置换术失败合并进行性距下关节关节炎3例,踝关节融合术失败合并进行性距下关节关节炎5例,马蹄内翻足合并继发性关节炎1例.术后采用影像学、EQ-5DTM功能评分、美国足踝外科协会(AOFAS)的踝-后足评分评价疗效. 结果 22例患者术后获14 ～38个月(平均21.3个月)随访,均获得功能位骨性融合,平均融合时间为3.9个月(2.4～6.2个月),术后影像学资料显示良好的后足力线.1例并发术后浅表感染,1例远端锁钉松动要求取出.术后1年的EQ-5DTM功能评分及AOFAS的踝-后足评分平均分别为69.3分(20 ～ 90分)及69.9分(45～85分). 结论 使用带外翻角的逆行髓内钉行胫距跟关节融合术治疗后足畸形可获得稳定的融合和良好的后足力线.%Objective To investigate the clinical effects of tibiotalocalcaneal arthrodesis (TTCA) using a retrograde intramedullary nail with a valgus curve.Methods At our department,22 patients underwent TTCA using a retrograde intramedullary nail with a valgus curve from June 2009 to January 2014 and were available for complete
follow-up.They were 12 men and 10 women,aged from 46 to 79 years (average,62.2 years).There were 3 cases of primary ankle osteoarthritis,9 ones of traumatic arthritis,one of ankle arthritis secondary to severe talar avascular necrosis,3 ones of progressive subtalar arthritis following failed ankle replacement,5 ones of progressive subtalar arthritis following failed ankle arthrodesis,and one of arthritis secondary to equinovarus.The outcome measurements included the American Foot and Ankle Society (AOFAS) ankle-hindfoot scale,EQ-5DTM functional score,radiologic assessment and clinical examination.Results The mean follow-up was 21.3 months (range,from 14 to 38 months).A plantigrade foot and bony union were achieved in all the patients after a mean time of 3.9 months (range,from 2.4 to 6.2 months).Postoperative radiologic results showed a good hindfoot alignment in all the patients.Superficial infection occurred in one patient and loosening of the distal screw in another who asked for removal.The mean postoperative EQ-5DTM functional score and AOFAS ankle-hindfoot score were 69.3 (range,from 20 to 90) and 69.9 (range,from 45 to 85),respectively.Conclusion TTCA using a retrograde curved intramedullary nail may lead to solid fusion and good hindfoot alignment. 【总页数】5页(748-752)
【关键词】足畸形;关节融合术;骨钉;关节炎
【作者】方真华;胡家朗;赵晶晶;陈明;郑琼;任义军;勘武生
【作者单位】430033 华中科技大学同济医学院附属普爱医院骨科;430033 华中科技大学同济医学院附属普爱医院骨科;430033 华中科技大学同济医学院附属普爱医院骨科;430033 华中科技大学同济医学院附属普爱医院骨科;430033 华中科技大学同济医学院附属普爱医院骨科;430033 华中科技大学同济医学院附属普爱医院骨科;430033 华中科技大学同济医学院附属普爱医院骨科 【正文语种】中文 【中图分类】 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-journal-orthopaedic-trauma_thesis/0201234518189.html 【相关文献】
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带外翻角的逆行髓内钉行胫距跟关节融合术治疗后足畸形
