关节镜下踝关节融合术治疗踝骨关节病的临床研究

发布时间：2018-05-20 21:54

本文选题：踝关节 + 关节病　；参考：《华北理工大学》2017年硕士论文

【摘要】：目的研究讨论关节镜下踝关节融合术治疗踝关节骨关节病的疗效价值。方法选取自2012年1月至2016年3月之间的23例(23踝)踝关节骨关节病患者,对其进行关节镜下踝关节融合术以治疗踝关节骨关节病。其中14例为创伤性关节炎,6例为骨性关节炎,3例为类风湿性关节炎,男13例,女10例。术前均排除临近关节病变或者其他导致下肢畸形的骨骼疾患,年龄分布在47岁~65岁范围,平均58岁。术前AOFAS功能评分平均26.91分。常规对所有患者行手术前后的负重位双踝关节正侧位X线片检查,并且确保所有患者投照条件均保持统一标准,术前在踝关节X线影像上观看临近关节是否存在病变,并进行手术前的设计。手术均采用关节镜下踝关节融合术,在关节镜下处理关节面的软骨及软骨下骨,处理完毕后维持踝关节于功能位,应用空心加压螺钉进行坚强的固定。患者术后均保持随访,时间平均为15月,在此期间密切观察患者术后情况、患侧踝关节状态变化以及骨性融合情况。结果对所有患者进行了平均长达15个月的随访,结果显示每位患者的踝关节都达到骨性融合标准。虽然术后患者踝关节活动度降低,但患者踝关节肿痛症状明显减轻或消失,术后患侧踝关节AOFAS功能评分明显提高,平均高达86.08分,患者生活质量明显得到提高。结论关节镜下踝关节融合术治疗踝关节骨关节病操作简单,术中创伤小,不破坏踝周组织结构,融合率高,术后恢复快、并发症少,早期效果良好,患者获得稳定、无痛的踝关节,能够从事部分体力劳动,是踝关节融合的理想方法。
[Abstract]:Objective to study the effect of arthroscopic ankle arthrodesis on ankle osteoarthropathy. Methods from January 2012 to March 2016, 23 patients with ankle osteoarthropathy were treated with arthroscopic ankle arthrodesis. Among them, 14 cases were traumatic arthritis, 6 cases were osteoarthritis, 3 cases were rheumatoid arthritis, 13 cases were males and 10 cases were females. All patients were excluded from adjacent articular lesions or other bone diseases leading to deformities of lower extremities. The age ranged from 47 to 65 years (mean 58 years). Preoperative AOFAS score averaged 26.91. Before and after operation, all patients were routinely examined with radiographs on the front and side sides of the bilateral ankle joints in the loading position, and to ensure that the radiographic conditions of all the patients remained uniform, and to observe whether there were lesions in the adjacent joints on the X-ray images of the ankle joints before and after the operation. The design before operation was carried out. Arthroscopic treatment of articular cartilage and subchondral bone were used to maintain the functional position of the ankle joint and the hollow compression screw was used for strong fixation. All the patients were followed up for an average of 15 months. During this period, the condition of the patients, the status of the affected ankle and the condition of bone fusion were closely observed. Results all patients were followed up for an average of 15 months. Although the motion of ankle joint decreased after operation, the symptoms of swelling and pain of ankle were obviously alleviated or disappeared. The score of AOFAS function of the affected side of ankle was obviously improved after operation, and the average score was up to 86.08, and the quality of life of the patients was obviously improved. Conclusion arthroscopic arthrodesis for the treatment of ankle osteoarthropathy is simple, with less trauma, no destruction of perimalleolar tissue structure, high fusion rate, rapid postoperative recovery, less complications, good early effect and stable patients. Painless ankle joint, able to engage in part of physical labor, ankle fusion is the ideal method.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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