摘要
目的探讨可吸收棒原位固定技术治疗青少年Hepple Ⅱ型距骨骨软骨损伤的临床疗效。方法采用回顾性病例分析的方法收集2017年1月—2021年12月上海交通大学医学院附属第六人民医院收治的13例(13足)青少年Hepple Ⅱ型距骨骨软骨损伤患者的临床资料, 均采用可吸收棒原位固定技术治疗。13例患者中男性7例, 女性6例, 右足13例, 年龄(14.85±2.23)岁, 年龄范围12~18岁。根据术前及末次随访时的美国矫形足踝外科协会(AOFAS)踝-后足评分、视觉模拟评分(VAS)以及健康状况调查简表(SF-36)评分对患者的疗效和功能进行评价。正态分布的计量资料以均数±标准差(±s)表示, 组间比较采用t检验;偏态分布的计量资料以M(Q_1, Q_3)表示, 组间比较采用秩和检验。结果 13例青少年Hepple Ⅱ型距骨骨软骨损伤患者手术顺利, 术后均获得随访, 随访时间为(25.54±9.95)个月。术后所有患者伤口均Ⅰ期愈合, 未出现伤口感染、延迟愈合等并发症。术前AOFAS踝-后足评分、VAS以及SF-36评分分别为(58.62±3.55)、7.00(6.50, 8.00)、(68.38±4.81)分, 术后1年末次随访时分别为(97.38±2.73)、1.00(0.00, 1.00)、(91.15±4.28)分, 末次随访时较术前有明显改善, 两组相比差异具有统计学意义(P<0.05)。结论可吸收棒原位固定技术治疗青少年Hepple Ⅱ型距骨骨软骨损伤的短期临床效果良好, 能够促进软骨修复, 显著改善症状, 并发症少, 达到较高的临床满意度, 是一种安全、有效的手术治疗选择。
Objective To investigate the efficacy of osteochondral fragment fixation using bioabsorbable pins for HeppleⅡosteochondral lesions of the talus(OLT)in adolescents.Methods Retrospective case analysis was used.The clinical data and follow-up results of 13 adolescent patients(13 feet)with HeppleⅡOLT were all treated with osteochondral fragment fixation using bioabsorbable pins admitted to Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2017 to December 2021 were retrospectively analyzed.There were 7 males and 6 females,with 13 right feet.The age was(14.85±2.23)years old,ranged from 12 to 18 years old.According to the American orthopedic foot and ankle society(AOFAS)ankle-hindfoot score,visual analogue scale(VAS)and SF-36 score before operation and at the last follow-up were used to evaluate the efficacy and function of the patients.Measurement data with normal distribution were represented as mean±standard deviation(±s),and the comparison between groups was conducted using the t-test;The mearsurement data with skewness distribution were expressed by M(Q1,Q3),and rank-sum test was used for inter-group comparison.Results Thirteen adolescent patients(13 feet)with HeppleⅡOLT underwent surgery successfully and were followed up for(25.54±9.95)months.All wounds healed by first intention,and no complications such as wound infection and delayed healing occurred.Preoperative AOFAS ankle-posterior foot score,VAS and SF-36 score were 58.62±3.55,7.00(6.50,8.00)and 68.38±4.81,respectively.At the last follow-up,the scores were 97.38±2.73,1.00(0.00,1.00),91.15±4.28,respectively,and the results were significantly improved at the last follow-up,with the difference between the two groups statistically significant(P<0.05).Conclusion Osteochondral fragment fixation using bioabsorbable pins which can promote cartilage repair,significantly improve symptoms,and achieve better clinical satisfaction with fewer complications,is a safe and effective surgical treatment
作者
王诚
李学谦
傅绍菱
吴承霖
王嘉正
张解元
李广翼
邹剑
薛剑锋
苏琰
梅国华
宋国勋
顾文奇
施忠民
Wang Cheng;Li Xueqian;Fu Shaoling;Wu Chenglin;Wang Jiazheng;Zhang Jieyuan;Li Guangyi;Zou Jian;Xue Jianfeng;Su Yan;Mei Guohua;Song Guoxun;Gu Wenqi;Shi Zhongmin(Department of Orthopedics,Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China)
出处
《国际外科学杂志》
2023年第7期473-480,I0007,I0008,共10页
International Journal of Surgery
基金
上海交通大学"交大之星"计划医工交叉研究基金(YG2022ZD018)
宁夏回族自治区重点研发计划(2020BCH01001)。
关键词
青少年
软骨疾病
距骨
可吸收棒
骨软骨块固定
Adolescent
Cartilage diseases
Talus
Bioabsorbable pin
Osteochondral fragment fixation
