结合Ilizarov技术行胫跟或胫距跟融合同期治疗踝关节感染并骨缺损疗效分析

发布时间：2018-10-20 15:35

【摘要】：目的探讨应用Ilizarov技术行胫跟或胫距跟融合同期治疗踝关节感染并骨缺损的效果。方法 2014年1月—2016年4月,应用Ilizarov技术行胫跟或胫距跟融合同期治疗踝关节感染并骨缺损14例。其中男12例,女2例;年龄25~61岁,平均39.8岁。踝关节感染原因:外伤12例,其中高处坠落伤5例,摔伤4例,交通事故伤1例,砸伤1例,扭伤1例;血源性2例。入院前曾行手术0~8次,平均3.7次。术前改良美国矫形足踝协会(AOFAS)踝与后足评分为(30.25±3.54)分。病程1~30个月,平均10.3个月。结果患者术后切口均Ⅰ期愈合,无感染复发,均未行二期植骨融合等手术干预。1例患者诉行走时间30 min后出现踝关节周围轻度疼痛及肿胀,未行特殊处理;患者术后出现0~3次不同程度针眼红肿情况,经相应处理后缓解。14例均获随访,随访时间6~27个月,平均16.8个月。除2例尚未拆除外固定架(带架时间分别为6、8个月),其余患者均于术后6~14个月,平均9个月拆除外固定架,均恢复行走功能。拆架后改良AOFAS踝与后足评分为(70.92±1.05)分,与术前比较差异有统计学意义(t= 10.992,P=0.000)。结论结合Ilizarov技术行胫跟或胫距跟融合同期治疗踝关节感染并骨缺损是一种简便有效的治疗方法。
[Abstract]:Objective to investigate the effect of tibial heel or tibial heel fusion with Ilizarov in the treatment of ankle infection and bone defect. Methods from January 2014 to April 2016, 14 patients with ankle infection and bone defect were treated with tibial heel or tibial heel fusion with Ilizarov technique. There were 12 males and 2 females with an average age of 39.8 years (2561 years). The causes of ankle infection were 12 cases of trauma, 5 cases of falling injury, 4 cases of falling injury, 1 case of traffic accident, 1 case of smashing injury, 1 case of sprain, and 2 cases of blood source. Eight operations were performed before admission, with an average of 3.7. The preoperative (AOFAS) and hind foot scores of the modified American Association of Orthopaedic ankles were (30.25 卤3.54). The course of disease ranged from 1 to 30 months with an average of 10.3 months. Results all the incisions healed in the first stage, no infection recurred, and no secondary bone grafting and fusion were performed. One patient complained of mild pain and swelling around the ankle after 30 min of walking time, without special treatment. There were 3 times of different degree of needle-eye redness after operation, which was relieved by corresponding treatment. 14 cases were followed up for 6-27 months (mean 16.8 months). Except for 2 patients who had not removed the external fixator (6 months and 8 months respectively), the other patients were removed from 6 to 14 months after operation, and the external fixator was removed for an average of 9 months, and the walking function was restored. The scores of modified AOFAS ankle and hind foot were (70.92 卤1.05), which were significantly different from those before operation (t = 10.992 卤0.000). Conclusion tibial heel or tibial heel fusion combined with Ilizarov technique is a simple and effective method for the treatment of ankle infection associated with bone defect.
【作者单位】：河南省洛阳正骨医院河南省骨科医院骨髓炎一科;河南科技大学第二附属医院VIP科;
【分类号】：R687.3

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