关节镜辅助下踝关节融合术的临床应用与体会-现代医学

关节镜辅助下踝关节融合术的临床应用与体会

单位：南京医科大学附属南京医院/南京市第一医院骨科, 江苏南京 210006

分类号：R684

出版年·卷·期（页码）：2017·36·第十一期（1603-1606）

摘要：

目的：探讨关节镜辅助下踝关节融合术的临床疗效。方法：2011年3月至2015年7月对19例踝关节晚期病变患者行关节镜辅助下踝关节融合术。其中男11例，女8例；年龄48～75岁，平均65.3岁。左侧12例，右侧7例；踝关节重度骨关节炎4例，踝关节创伤性关节炎15例。所有患者术前均进行踝关节磁共振检查，以评估踝关节软骨的情况。记录术前和术后1年的疼痛评分，评价临床疗效。结果：所有患者获得24～36个月的随访，未出现切口愈合不良和感染的早期并发症。患者（12±1）周可获得骨性融合。术前疼痛评分为（7.8±1.3）分，术后1年为（2.1±0.9）分，差异具有统计学意义（P<0.05）。结论：关节镜辅助下行踝关节融合术，手术疗效确切，具有手术创伤小、切口美观、融合率高等优势，值得临床推广应用。

Objective:To investigate the approach and clinical results of arthroscopic ankle arthrodesis. Methods:From March 2011 and July 2015, 19 patients(11 men and 8 women) underwent arthroscopic ankle arthrodesis. Mean age at surgery was 65.3 years(48-75 years). 12 cases were on the left side, 7 cases were on the right side. 4 cases were of severe osteoarthritis, 15 post-traumatic osteoarthritis. All the patients underwent preoperative ankle magnetic resonance imaging (MRI) to assess the damage of ankle cartilage. Clinical outcome were assessed according to pre- and postoperative pain scores 1 year after surgery. Results:All the patients completed 24-36 months follow-up. There were no peri-operative complications such as poor healing of incision or infection. The average time for fusion was (12±1) weeks, with a range of 10 to 15 weeks. Preoperative pain scores(7.8±1.3), postoperative pain scores 1 year after surgery(2.1±0.9). The difference was statistically significant. Conclusion:In our study, arthroscopic ankle arthrodesis has resulted in good functional outcome with minimum and cosmetic incisions and a high fusion fate, worthy of clinical popularization and application.

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