摘要
目的探讨微创有限截骨联合Ilizarov外固定架对重度马蹄内翻足患者足踝关节和患肢步行运动功能的影响。方法选取2020年1月至2021年10月中国人民解放军东部战区总医院镇江医疗区收治的56例重度马蹄内翻足患者作为研究对象,按照随机数字表法分为两组。对照组(28例)患者行Ilizarov外固定架治疗,试验组(28例)患者行微创有限截骨联合Ilizarov外固定架治疗,两组患者均于术后随访6个月。比较两组患者术前与术后3个月国际马蹄足畸形研究学组(ICFSG)评分,术前与术后1、3、6个月美国骨科足踝外科协会(AOFAS)评分,术前与术后6个月步速、步长及6 min步行距离,以及术后6个月并发症发生情况。结果与术前比,术后3个月两组患者形态特征、功能状况、X线片表现等ICFSG评分均显著降低,且试验组显著低于对照组;与术前比,术后1、3、6个月两组患者AOFAS评分均逐渐升高,且试验组术后1、3、6个月AOFAS评分与对照组比均显著升高;与术前比,术后6个月两组患者步速均显著加快,试验组显著快于对照组;两组患者步长、6 min步行距离均显著延长,试验组显著长于对照组(均P<0.05);两组患者术后6个月并发症总发生率比较,差异无统计学意义(P>0.05)。结论微创有限截骨联合Ilizarov外固定架治疗重度马蹄内翻足患者,其治疗效果良好,可延长6 min步行距离,提高步速,有效改善患者患肢步行运动功能与足踝功能,且安全性良好。
Objective To investigate the effect of minimally invasive limited osteotomy combined with Ilizarov external fixator on the ankle function and the walking motor function of the affected limb in patients with severe clubfoot.Methods A total of 56 cases patients with severe clubfoot who were admitted to the Zhenjiang Medical District,General Hospital of Eastern Theater Command,PLA from January 2020 to October 2021 were selected as the research subjects and divided into two groups according to the random number table method.Patients in the control group(28 cases)were treated with Ilizarov external fixator,while patients in the experimental group(28 cases)were treated with minimally invasive limited osteotomy combined with Ilizarov external fixator,all patientsin of both groups were followed up for 6 months after operation.The scores of the International Club Foot Study Group(ICFSG)of patients before and 3 months after the operation,and the scores of the American Orthopaedic Foot and Ankle Surgeons(AOFAS)before and 1,3,6 months after the operation,the step speed,step length and 6-min walking distance before and 6 months after operation,as well as the postoperative complications occurrence during the 6 months after operation of patients were compared between the two groups.Results Compared with before operation,the ICFSG scores of morphological characteristics,functional status,X-ray photograph performance of patients in the two groups decreased significantly 3 months after the operation,and the experimental group was significantly lower than the control group;compared with before operation,the AOFAS scores of patients in the two groups increased significantly 1,3,6 months after operation,and the AOFAS scores of patients in the experimental group 1,3,6 months after operation were significantly higher than those of the control group;compared with before operation,the step speed of patients in the two groups accelerated significantly 6 months after operation,and the experimental group was significantly faster than the co
作者
栾峰
黄超
李桓毅
崔锁明
LUAN Feng;HUANG Chao;LI Huanyi;CUI Suoming(Department of Orthopedics,Zhenjiang Medical District,General Hospital of Eastern Theater Command,PLA,Zhenjiang,Jiangsu 212008,China)
