中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (13): 2370-2373.doi: 10.3969/j.issn.1673-8225.2012.13.021

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

胫骨开槽与环锯法踝关节融合后临近关节退变的比较★

朱法豪，张洪涛，杨惠林，倪  莉，程  宇，胡  海   

  1. 苏州大学附属第一人民医院骨科，江苏省苏州市 215006
  • 收稿日期:2011-12-10 修回日期:2012-01-14 出版日期:2012-03-25 发布日期:2012-03-25
  • 通讯作者: 张洪涛，博士，副主任医师，苏州大学附属第一人民医院骨科，江苏省苏州市 215006 htzhang@163.com
  • 作者简介:朱法豪★，1986年生，山东省泰安市人，苏州大学附属第一人民医院在读硕士，主要从事脊柱及关节方面的研究。 zfh1986@126.com

Effect of tibia slotting versus trephine for ankle fusion on the degeneration of the adjacent joint

Zhu Fa-hao, Zhang Hong-tao,Yang Hui-lin, Ni Li, Cheng Yu, Hu Hai   

  1. Department of Orthopedics, First Affiliated People’s Hospital of Soochow University, Suzhou  215006, Jiangsu Province, China
  • Received:2011-12-10 Revised:2012-01-14 Online:2012-03-25 Published:2012-03-25
  • Contact: author: Zhang Hong-tao, Doctor, Associate chief physician, Department of Orthopedics, First Affiliated People’s Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China htzhang@163.com
  • About author:Zhu Fa-hao★, Studying for master’s degree, Department of Orthopedics, First Affiliated People’s Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China zfh1986@126.com

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摘要：

背景：由于踝关节的特殊解剖结构，踝关节融合的方法较多并各有优势。
目的：比较胫骨开槽法及环锯法行踝关节融合的临床疗效。
方法：于2002-02/2011-02对苏州大学附属第一人民医院骨科招募的35例行踝关节融合的患者，分别采用胫骨开槽(n=19)及环锯截骨法(n=16)治疗，并对其进行随访观察比较。
结果与结论：所有35例患者均获随访，随访时间为8~96个月。胫骨开槽方法比环锯法踝关节融合手术时间长(P < 0.05)，术中出血量多(P < 0.05)。术后8个月胫骨开槽组患者美国足踝外科协会评分高于胫骨开槽组(P < 0.05)，胫骨开槽组有10例，环锯法有8例随访满5年，2组患者术后均有>1/3的患者出现临近关节退变症状。提示相较于环锯截骨法，环锯法行踝关节融合具有创伤小，操作简单，融合率高，并发症少等优点，但踝关节融合后临近关节的退变也不可忽视。
关键词：关节融合；踝关节；环锯；并发症；关节退变
doi:10.3969/j.issn.1673-8225.2012.13.021

关键词: 关节融合, 踝关节, 环锯, 并发症, 关节退变

Abstract:

BACKGROUND: Because of the special anatomy of the ankle joint, there are many methods in ankle fusion, and each has its own advantages.
OBJECTIVE: To analyze and compare the effect of tibia slotting versus trephine for ankle fusion discuss the degeneration of adjacent joints.
METHODS: A retrospective study was carried out in 35 patients with ankle from February 2002 to February 2011 in the First Affiliated People’s Hospital of Soochow University. We used trephine (n=16) and slotted (n=19) in the tibia to fuse the patients’ ankle joint, then the effect was analyzed and compared.
RESULTS AND CONCLUSION: All the 35 patients were followed-up for 8-96 months. The duration of ankle arthrodesis by tibia slotting was longer than that by trephine (P < 0.05), and the intraoperative blood loose was more (P < 0.05). The average American College of Foot and Ankle Society score at the 8th month follow-up in the tibia slotting group was higher than that in the trephine group (P < 0.05). Eighteen of the 35 patients were followed-up for at least 5 years, 10 cases in the tibia slotting group and 8 cases in the trephine group. Over one third of the patients in both two groups occurred adjacent joint degeneration. Compared with slotting in the tibia, trephine for ankle arthrodesis was a simple operation with small wound, higher fusion rate and less complications. However, the degeneration of the near joint should not be ignored.
 

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