摘要
目的观察踝上截骨术治疗踝关节合并距下关节骨性关节炎(OA)的疗效。方法回顾性分析2016年5月至2021年5月在沧州市人民医院进行踝上截骨术且随访时间≥1年的43例(43足)踝关节合并距下关节OA患者临床资料,按照不同的治疗措施分两组,即A组(n=20,保留腓骨)与B组(n=23,截断腓骨)。比较两组的疗效、踝关节功能、踝关节活动度、影像学测量指标、骨性愈合时间。结果A组优良率(75.00%)与B组(82.61%)比较,差异无统计学意义(P>0.05)。术后,两组的美国足踝外科踝-后足评分量表(AOFAS)评分、踝关节活动度、胫骨远端关节面角(TAS)、胫骨踝穴角(TC)较术前高,踝关节骨关节炎量表(AOS)疼痛评分、AOS功能评分、距骨倾斜角(TT)较术前低,差异均有统计学意义(P<0.05),胫骨侧位关节面角(TLS)较术前差异无统计学意义(P>0.05);但术后两组的AOFAS评分、AOS疼痛评分、AOS功能评分、踝关节活动度、TAS、TLS组间比较,差异均无统计学意义(P>0.05),B组的TT为(2.15±0.68)°,较A组[(3.02±0.59)°]低,TC为(80.59±2.05)°,较A组[(75.84±2.36)°]高,差异均有统计学意义(P<0.05)。A组骨性愈合时间为(3.72±0.38)个月,与B组[(3.89±0.65)个月]比较,差异无统计学意义(P>0.05)。结论踝上截骨术治疗踝关节合并距下关节OA疗效肯定,可改善踝关节功能、踝关节活动度、影像学测量指标,利于骨性愈合,同时进行腓骨截骨在改善TT、TC方面效果更好。
Objective To observe the curative effect of supra-ankle osteotomy in the treatment of ankle joint with subtalar osteoarthritis(OA).Methods The clinical data of 43 patients(43 feet)with ankle joint complicated with subtalar OA who underwent supra-ankle osteotomy in Cangzhou people’s Hospital from May 2016 to May 2021 and were followed up for≥1 year were retrospectively analyzed.Based on different treatment measures,they were grouped into 2 groups,namely group A(n=20,fibula preserved)and group B(n=23,fibula cut off).The curative effect,ankle function,ankle range of motion,imaging measurements,and bone healing time were compared between the two groups.Results There was no significant difference in the excellent and good rate of group A(75.00%)and group B(82.61%)(P>0.05).After operation,the American Foot and Ankle Surgery Ankle-Hindfoot Scale(AOFAS)score,ankle range of motion,distal tibial articular surface angle(TAS),and tibial ankle point angle(TC)in the two groups were higher than those before operation,the Ankle Osteoarthritis Scale(AOS)pain score,AOS function score,talus tilt angle(TT)were smaller than those before operation,the differences were statistically significant(P<0.05),there was no obvious difference in tibial lateral articular surface angle(TLS)compared with before operation(P>0.05),however,there was no obvious difference in AOFAS score,AOS pain score,AOS function score,ankle range of motion,TAS and TLS between the two groups after operation(P>0.05),the TT of group B was(2.15±0.68)°,which was lower than that of group A[(3.02±0.59)°],and the TC was(80.59±2.05)°,which was higher than that of group A[(75.84±2.36)°],the differences were statistically significant(P<0.05).The bone healing time of group A was(3.72±0.38)months,and compared with group B[(3.89±0.65)months],the difference was not statistically significant(P>0.05).Conclusion Supra-ankle osteotomy in the treatment of ankle combined with subtalar OA has a positive effect.It can improve ankle function,ankle range of motion,and imaging
作者
刘宣毅
李冕
张官锋
徐亦鹏
闫石
LIU Xuan-yi;LI Mian;ZHANG Guan-feng(Department of Hand and Foot Surgery,Cangzhou People's Hospital,Cangzhou Hebei 061000,China)
出处
《临床和实验医学杂志》
2022年第18期1992-1995,共4页
Journal of Clinical and Experimental Medicine
基金
河北省2022年度医学科学研究课题(编号:20220328)。
