天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (3): 308-310.doi: 10.11958/j.issn.0253-9896.2015.03.023

• 应用研究 • 上一篇    下一篇

关节融合术治疗重度 僵硬 30 例疗效分析

赵晓涛， 高翔△， 张殿英， 郁凯， 董胜利， 李建鹏#br#   

  1. 天津市第五中心医院骨科 （邮编 300450）

  • 收稿日期:2014-09-12 修回日期:2014-11-10 出版日期:2015-03-15 发布日期:2015-03-15
  • 通讯作者: 高翔 E-mail:tjwzxgx@126.com
  • 作者简介:赵晓涛 （1985）， 男， 硕士研究生， 主要从事足踝外科、 创伤骨科研究

Analysis of results of arthrodesis in 30 patients with severe hallux rigidus

ZHAO Xiaotao, GAO Xiang△, ZHANG Dianying, YU Kai, DONG Shengli, LI Jianpeng#br# #br#   

  1. Department of Orthopedic Surgery, The Fifth Central Hospital of Tianjin, Tianjin 300450, China

  • Received:2014-09-12 Revised:2014-11-10 Published:2015-03-15 Online:2015-03-15
  • Contact: GAO Xiang E-mail:tjwzxgx@126.com

PDF (PC)

4069

摘要： 目的 探讨关节融合术治疗重度 僵硬的临床疗效。方法 回顾性分析 2010 年 1 月—2013 年 1 月经关节融合术治疗的重度 僵硬患者 30 例 （30 足）， 采用 AOFAS、 VAS 评分系统评价临床疗效， 获得融合率、 融合时间及外翻发生率。测量手术前后第 1~5 跖骨头下压力分布改变情况。结果 平均随访时间 18 个月， 术后患者 AOFAS 评分、 VAS 评分高于术前（72.8±6.2 vs 48.2±7.6， 8.3±1.1 vs 1.7±0.7， 均 P ＜ 0.01）； 融合部位平均愈合时间为 12.1 周，未出现融合失败及 外翻畸形。第 1~5 跖骨头下压力分布较术前由异常外侧分布向正常负重分布恢复。结论 关节融合术可有效治疗重度 僵硬， 解除疼痛症状， 恢复前足底压力分布， 并发症少。

关键词: 僵硬, 关节融合术, 转移性跖痛, 足底压力

Abstract: Objective To observe the clinical effect of arthrodesis in treating severe hallux rigidus. Methods Totally 30 patients (30 feet) with severe hallux rigidus treated by arthrodesis from January in 2010 to January in 2013 were retrospec⁃ tively analyzed. AOFAS and VAS scoring system were employed to evaluate the clinical curative effect including acquiring the fusion rate, the time to fusion and the incidence rate of hallux valgus. Forefoot-plantar pressure values before and after operation were measured by Plantar pressure measurement system. Results The mean follow-up time was 18 months. AO⁃ FAS score was raised from (48.2±7.6) to (72.8±6.2) after operation (P＜0.01). VAS score was also increased from (1.7±0.7) to (8.3±1.1) after operation (P＜0.01). The average healing time of knitting was 12.1 weeks. None was non-union and devel⁃ oped to hallux valgus. The forefoot-plantar pressure returned to normal postoperatively from abnormal laterally distribution. Conclusion The surgical strategy of arthrodesis is proved to be effective in treating severe hallux rigidus, in terms of capa⁃ bility of relief from pain, recovery of forefoot-plantar pressure distribution, low incidence of complication.

Key words: hallux rigidus, arthrodesis, transfer metatarsalgia, plantar pressure