摘要
目的 踝关节融合的方法很多,但临床效果不确实,并多伴有骨折不愈合及皮肤坏死等术后并发症。评价胫骨髓内钉用于胫距、距下关节创伤性关节炎关节融合的短期临床疗效。方法 应用胫骨髓内钉治疗踝关节创伤性关节炎病例共21例。其中,男15例,女6例,年龄32∽65岁,平均49.8岁。手术均采用逆行打入胫骨髓内钉、关节间隙充分植骨的方法固定胫距及距下关节,术后常规治疗及康复训练,并定期进行随访,对其疗效进行归纳、分析及总结。结果 未出现失访病例,术后随访时间6∽40个月,平均23.6个月。伤口均I甲愈合,未出现伤口坏死或骨折不愈合。其中有2名患者主诉平地行走时有轻到中度疼痛,1例患者上坡路行走时有轻度疼痛。术后6个月AOFAS平均为72.8分（59.0∽78.0分）。结论 胫骨髓内钉固定稳定可靠,可早期功能锻炼,骨性融合良好,术后功能恢复良好,治疗效果明显。
[ Objective] There are so many therapeutic methods for ankle arthrodesis, but the clinical effects are uncertain, most of the patients have the complications, such as nonunion or skin necrosis. The aim of this study was to evaluate the outcome of tibiotalocalcaneal fusion in traumatic arthritis patients using the tibial intramedullary nail. [ Method ] 18 patients were enrolled in this study, thirteen males and five females, with an average age of 49.8years （32-65）. Retrograded tibial intramednllary nail and sufficient bone grafted in the joint space were proceeded during the operation. Conventional rehabilitative exercises were started as soon as postoperation, and then the effects were analyzed and summarized. [ Result ] All of the patients were followed-up for 6months to 40 months, with average 23.6 months. The wounds were healed up well and didn＇t appear nonunion or skin necrosis. Two patients were found mild to moderate pain while walking on even surface, and 1 mild pain on uneven surface. The average AOFAS score improved to 72.8 （ranged, 59.0-78.0） points 6 months after the operation. [ Conclusion ] Tibial intramedullary nail fixation is effective. It＇s fixed stable and reliable, allowing early weight-beating, good bony fusion and good functional recovery.
出处
《中国现代医学杂志》
CAS
北大核心
2015年第4期56-59,共4页
China Journal of Modern Medicine
关键词
踝关节
创伤性关节炎
关节融合
髓内钉
ankle joint
traumatic arthritis
joint fusion
intramedullary nail
