| 改良小L形入路距下关节撑开植骨融合治疗陈旧性跟骨骨折距下关节炎 |
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投稿时间：2014-06-17
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| 作者 | Author | 单位 | Address | E-Mail |
| 李毅 |
LI Yi |
西安交通大学医学院附属红会医院足踝外科, 陕西 西安 710054 |
Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shaanxi, Chinese |
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| 赵宏谋 |
ZHAO Hong-mou |
西安交通大学医学院附属红会医院足踝外科, 陕西 西安 710054 |
Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shaanxi, Chinese |
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| 梁晓军 |
LIANG Xiao-jun |
西安交通大学医学院附属红会医院足踝外科, 陕西 西安 710054 |
Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shaanxi, Chinese |
liangjun33369@163.com |
| 刘诚 |
LIU Cheng |
西安交通大学医学院附属红会医院足踝外科, 陕西 西安 710054 |
Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shaanxi, Chinese |
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| 赵恺 |
ZHAO Kai |
西安交通大学医学院附属红会医院足踝外科, 陕西 西安 710054 |
Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shaanxi, Chinese |
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| 杨杰 |
YANG Jie |
西安交通大学医学院附属红会医院足踝外科, 陕西 西安 710054 |
Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shaanxi, Chinese |
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| 期刊信息：《中国骨伤》2014年，第27卷，第7期，第536-539页 |
| DOI：10.3969/j.issn.1003-0034.2014.07.002 |
| 基金项目: |
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中文摘要:
目的：观察改良跟腱旁后外侧小“L”入路距下关节撑开植骨融合治疗陈旧性跟骨骨折距下关节炎的疗效。
方法：2009年3月至2012年9月，应用改良小“L”入路距下关节撑开植骨融合术治疗22例跟骨骨折伴距下关节炎患者，男13例，女9例；年龄22～49岁，平均35.3岁。病程11～32个月，平均21个月。根据Stephens-Sanders分型，Ⅱ型16例，Ⅲ型6例。通过改良AOFAS踝与后足评分标准对手术前后患足功能进行评估，比较改善程度。
结果：1例出现皮缘坏死，无感染、螺钉断裂、植骨吸收及距骨坏死等情况发生。术后21例获随访，时间18～46个月，平均29个月。术后4个月融合处均获骨性愈合。末次随访时改良AOFAS评分由术前32～65分（平均50.8分）提高至末次随访66～92分（平均82.6分），与术前比较差异有统计学意义（P<0.01）.
结论：改良小“L”入路距下关节撑开植骨融合术是治疗陈旧性跟骨骨折并发距下关节炎的一种有效方法，临床操作简单，并发症少，可矫正跟骨骨折畸形愈合的主要病理改变，恢复足部外形并改善后足功能。 |
| 【关键词】跟骨 骨折 距下关节 骨关节炎 关节融合术 骨移植 |
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| Modified limited L incision with distraction bone block arthrodesis for subtalar osteoarthritis |
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ABSTRACT
Objective: To evaluate the functional outcomes of modified limited "L" incision beside the Achilles tendon with distraction bone block arthrodesis in treatment of subtalar osteoarthritis.
Methods: From March 2009 to September 2012,a total of 22 cases of old calcaneus fractures with subtalar osteoarthritis were treated with modified limited "L" incision and distraction bone block arthrodesis including 13 males and 9 females with a mean age of 35.3 years old (ranged 22 to 49). The mean time from calcaneal fracture was 21 months (ranged 11 to 32). According to the Stephens-Sanders classification,16 cases were type Ⅱ and 6 were type Ⅲ. The modified-AOFAS ankle-hindfoot score was used for functional outcomes evaluation.
Results: There was one incision necrosis and no infection,implant failure,bone-graft absorbed or talus necrosis was note at the follow-up time. A total of 21 cases were followed up for a mean time of 29 months (ranged from 18 to 46 months). All of the cases reached a bony union within 4 months postoperation. The mean modified-AOFAS ankle-hindfoot score was 82.6 points (ranged from 66 to 92 points),reached a significantly improvement in comparing with the mean preoperative score (50.8 points,ranged from 32 to 65 points,P<0.01).
Conclusion: The modified limited"L" incision beside the Achilles tendon with distraction bone block arthrodesis is an acceptable and alternative treatment method for subtalar osteoarthritis. This method is easy to use and with less complication. It can correct the main pathological changes and reach good functional outcomes. |
| KEY WORDS Calcaneus Fractures Sbtalar joint Osteoarthritis Arthrodesis Bone transplantation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李毅,赵宏谋,梁晓军,刘诚,赵恺,杨杰.改良小L形入路距下关节撑开植骨融合治疗陈旧性跟骨骨折距下关节炎[J].中国骨伤,2014,27(7):536~539 |
| 英文格式: | LI Yi,ZHAO Hong-mou,LIANG Xiao-jun,LIU Cheng,ZHAO Kai,YANG Jie.Modified limited L incision with distraction bone block arthrodesis for subtalar osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(7):536~539 |
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