逆行交锁髓内钉治疗胫距及距下关节创伤性关节炎Retrograde intramedullary nail for traumatic tibiotalocalcaneal arthritis
葛亮;苟三怀;欧阳跃平;刘岩;席焱海;李阳;
摘要(Abstract)：
[目的]评价逆行交锁髓内钉用于胫距、距下关节创伤性关节炎关节融合的效果。[方法]应用关节间隙植骨融合加钛合金逆行交锁髓内钉固定术治疗创伤性胫距及距下关节退变18例,其中男8例,女10例。年龄42~69岁,平均57.5岁。9例伴踝外翻,2例伴马蹄內翻。手术距原发创伤的时间5~13年,平均7.6年。手术取部分远端腓骨植入关节间隙,自跟骨向胫骨逆行置钉并常规作近、远端锁钉。术前、术后对患者行AOFAS评分,并通过影像评价植骨融合效果。[结果]所有患者均获随访,随访时间6~22个月,平均13.5个月。术后切口愈合均正常,恢复负重的时间9~16周,平均13.6周。手术后1名患者出现腔隙性脑梗塞。1人(5%)于平地行走时中度疼痛;2人(11%)于崎岖路面上行走时出现轻-中度疼痛;1人(5%)站立时轻度疼痛。14人(79%)无疼痛。手术前后患者的AOFAS平均评分分别为43.5分(40~52分)和69分(56~84分)。13人(72%)植骨完全融合,时间12~48周,平均16.8周;3人(17%)不完全融合;2人(11%)未融合。[结论]植骨融合加逆行交锁髓内钉固定是治疗胫距、距下关节创伤性关节炎的有效方法。
关键词(KeyWords)： 逆行髓内钉;踝关节;创伤性关节炎;关节融合
基金项目(Foundation):
作者(Author): 葛亮;苟三怀;欧阳跃平;刘岩;席焱海;李阳;
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参考文献(References)：
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