引用本文:[点击复制]
[点击复制]
【打印本页】 【在线阅读全文】【下载PDF全文】 查看/发表评论下载PDF阅读器关闭

←前一篇|后一篇→

过刊浏览    高级检索

本文已被:浏览 196次   下载 40 本文二维码信息
码上扫一扫!
不同手术方式治疗创伤性踝关节炎临床疗效对比
马延辉,王磊,张杰,董喆
0
(延安大学附属医院骨科,陕西 延安 716000)
摘要:
目的 分析比较3种不同手术方式治疗创伤性踝关节炎的临床疗效,旨在为临床治疗提供理论依据。方法 选取本院2011年1月~2013年4月收治的90例创伤性踝关节炎患者,按照不同治疗方式将患者分为3组,每组30例,分别采用人工全踝关节置换术(踝关节置换组)和踝关节融合外架固定术(踝关节融合外架固定组)、踝关节融合内固定术(踝关节融合内固定组)。踝关节置换组患者平均随访时间为(34.56±3.42)个月,踝关节融合外架固定组患者平均随访时间为(33.14±3.26)个月,踝关节融合内固定组患者平均随访时间为(36.78±4.57)个月。观察比较3组患者术前、术后AOFAS踝后足评分、术后生活质量改善情况以及早期临床疗效。结果 3组患者在年龄、性别、随访时间、体重指数(BMI)、术前活动度等临床资料比较无差异(P>0.05),但踝关节置换组术后踝关节活动度较术前明显改善(P<0.05);术前3组患者AOFAS踝后足评分比较无差异(P>0.05),术后3组患者AOFAS踝后足评分均有升高,但踝关节置换组AOFAS踝后足评分明显高于踝关节融合外架固定组及踝关节融合内固定组(均P<0.05),而踝关节融合外架固定组及踝关节融合内固定组间AOFAS踝后足评分比较无差异(P>0.05);术前3组患者SF-36评分比较无差异(P>0.05),术后3组患者SF-36评分均有升高,但踝关节置换组SF-36评分明显高于踝关节融合外架固定组与踝关节融合内固定组(均P<0.05),而踝关节融合外架固定组与踝关节融合内固定组间SF-36评分比较无差异(P>0.05);创伤性踝关节炎术后都存在一定的并发症,主要包括骨不连、假体松动、浅深部感染、对位对线不良等,踝关节置换组并发症发生率为20.00%,踝关节融合外架固定组并发症发生率为26.67%,踝关节融合内固定组并发症发生率为26.67%,3组并发症发生率比较无差异(P>0.05)。结论 采用人工全踝关节置换术治疗创伤性踝关节炎比踝关节融合术疗效更好,能更快地改善患者的生活质量,且没有增加患者术后并发症的发生率,可在临床推广应用。
关键词:  人工全踝关节置换术  踝关节融合外架固定术  踝关节融合内固定术  创伤性踝关节炎  临床疗效
DOI:
基金项目:陕西省教育厅科研项目(2011658)
Comparative analysis of the curative effects of traumatic ankle arthritis treated with three different surgical methods
MA Yanhui,WANG Lei,ZHANG Jie,DONG Jie
(Department of Orthopedics, The Affiliated Hospital of Yan'an University, Yan'an 716000, Shanxi, China)
Abstract:
Objective To analyze the clinical curative effect of three different surgical methods for the treatment of traumatic ankle arthritis and provide a theoretical basis for clinical treatment. Methods 90 patients with traumatic ankle arthritis admitted to our hospital from January 2011 to April 2013 were selected and divided into 3 groups according to different treatment methods (Each group of 30 cases). The patients were treated with artificial total ankle replacement (ankle replacement group), ankle arthrodesis external fixation (ankle arthrodesis external fixation group) and ankle joint fusion internal fixation (ankle arthrodesis group). The mean followup time was (33.14±3.26) months in the ankle fusedexternal fixation group and (36.78±4.57) months in the ankle arthrodesis group. The ankle hindfoot score, the postoperative quality of life improvement and the early clinical curative effect of the three groups were observed before and after operation. Results〓No significant difference was detected in age, sex, followup time, body mass index (BMI), preoperative activity and other data of three groups (P>0.05), but the activity of ankle joint replacement group significantly improved (P<0.05). No difference was detected in the scores of AOFAS between the three groups (P>0.05). The postoperative anklehindfoot score of AOFAS increased in all three groups. The ankle hindfoot score of the ankle arthroplasty group was significantly higher than that of the ankle arthrodesis group (P<0.05). No significant difference was detected in anklehindfoot score between the ankle fusion and the ankle joint fixation group (P>0.05). There was no significant difference in SF-36 score between the three groups before operation (P> 0.05). The SF-36 scores of the three groups after operation were all increased, but the SF-36 score of the ankle joint replacement group was significantly higher than that of the ankle arthrodesis group (P<0.05). No significant difference was detected in the score of SF-36 between the anklefixation group and the anklejoint fusion group (P> 0.05), but the traumatic ankle was significantly lower in the ankle joint fixation group and the ankle joint fusion and internal fixation group. No significant difference was detected in SF36 score between the ankle fusion and the ankle fusion fixation group (P> 0.05). There were some complications after arthritis, including: nonunion, loosening of the prosthesis, shallow deep infection, poor alignment and so on. The complication rate in the ankle replacement group was 20.00%. The incidence rate of complications in the ankle arthrodesis group was 26.67%, and the incidence of complications in the ankle arthrodesis group was 26.67%. No difference was detected in the incidence of complications between the three groups (P>0.05). Conclusion The total ankle replacement in patients with traumatic ankle arthritis treat better than ankle arthrodesis curative effect, which can quickly improve the quality of life of patients. There is no increase in the incidence of postoperative complications, worthy of promotion in clinical use.
Key words:  Department of Orthopedics, The Affiliated Hospital of Yan'an University, Yan'an 716000, Shanxi, China

用微信扫一扫

用微信扫一扫