梁景棋;梁晓军;张言;刘培珑;李毅;鹿军;赵宏谋;

• 1:西安交通大学医学院附属红会医院足踝外科

摘要(Abstract)：

[目的]评价踝关节牵开成形术治疗中重度踝关节骨性关节炎的效果,并评估治疗失败的相关因素。[方法]纳入46例van DijkⅡ期和Ⅲ期踝关节骨性关节炎患者。其中男性15例,女性31例,年龄42-71岁,平均(54.82±6.28)岁,采用Ilizarov外固定架牵开踝关节间隙(AJSD)≥5 mm,术后2周负重,牵开10～14周拆除外固定架。通过踝关节骨关节炎评量表(AOS)及美国足踝外科协会(AOFAS)踝与后足评分评估踝关节功能。对术后距骨倾斜角及踝关节间隙进行评估分析,计算风险比率来评估相关的潜在失败因素。[结果]所有患者随访24～68个月,平均(42.76±10.21)个月。末次随访AOS和AOFAS评分均较术前显著改善,差异有统计学意义(P<0.05)。28例(60.87%)末次随访时AJSD与术前相比显著增宽,差异有统计学意义(P<0.001)。距骨倾斜角和踝关节活动度较术前差异无统计学意义(P>0.05)。10例(21.74%)治疗失败,治疗失败与距骨倾斜角增大(≥5°,RR=5.921,95%CI:1.802～19.479,P=0.003)和肥胖(RR=3.582,95%CI:1.302～9.891,P=0.010)有显著相关性。[结论]牵开成形术治疗踝关节骨性关节炎的早中期疗效肯定。然而,该术式的失败率仍然较高,特别是对于肥胖患者和距骨倾斜角较大的患者,应谨慎使用。

关键词(KeyWords)： 踝关节骨性关节炎;踝关节牵开成形术;并发症

Abstract:

Keywords:

基金项目(Foundation): 中国博士后科学基金面上项目(编号:2017M613178);; 陕西省博士后基金项目(编号:2017BSHQYXMZZ13)

作者(Author): 梁景棋;梁晓军;张言;刘培珑;李毅;鹿军;赵宏谋;

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DOI:

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