踝关节病人工踝关节置换.docVIP

踝关节病人工踝关节置换 　 作者：毛宾尧，胡裕桐，应忠追，司全明 【关键词】 人工踝关节 　　摘要：［目的］探讨人工踝关节置换治疗踝关节病的疗效。［方法］对1999~2004年1月的18例患者包括骨性踝关节炎6例，创伤性踝关节炎9例，局限性距骨缺血坏死2例，踝关节融合后1例，均采用Link STAR假体3构件套进行人工踝关节置换。18例中，男13例，女5例;平均年龄477岁(38~67）。［结果］随访平均3 a 9个月(1~5 a）。按Kofoed评价系统观察疗效，优(85~100）16例，良(75~84）2例，无可(70~74）和差(＜70）。患足背屈平均8°(范围6°~12°），跖屈12°(范围8°~16°），背屈和跖屈平均16°(11°~23°）。并发症有切口皮缘坏死2例，无足内、外翻和影像学松动。［结论］人工踝关节置换是治疗和替代踝关节多种疾患疼痛和需要融合的良好方法。 　　关键词：踝关节；人工踝关节；置换；外科 　　Treatment of ankle disorders with total ankle replacement∥ 　　Abstract：［Objective］To study the result of treatment for ankle disorders with total ankle replacement［Method］From Jan1999 to Jan2004,eighteen cases included ankle osteoarthritis in six cases,traumatic arthritis in nine,local necrosis of the talus in two,and post of ankle arthrodesis in oneThey were treated with total ankle replacement which be made in WeLink STAR prostheseAmong the eighteen cases,thirteen male,and five femaleThe patients mean age was 477(range 38~67）［Result］The term of followup was three years and nine months(ranged 1~5 years）The ankle functions were evaluated with Kofoeds system,excellent(85~100）in 16 cases,good (75~84）in 2,no fair (70~74）and poor (＜70）The foot dorsiflexion averaged 8° (ranged 6°~12°）and plantoflexion 12° (range 8°~16°）Movement range of the foot dorsiflexion and plantoflexion were 16° (averaged 11°~23°）The implication was the skin necrosis of incise bordgerNo ersion,eversion and radiographic loosen［Conclusion］Total ankle replacement is a good method for the ankle disorders and instead to the intraditional ankle arthrodesis 　　Key words：Ankle joint;Total ankle prosthesis;Replacement;Surgery 　　治疗严重的踝关节病，长期沿习采用踝关节融合术。能否采取人工活动关节治疗疼痛踝关节病，是继髋膝关节人工关节置换治疗取得优良成绩后，一直探索不辍的课题。历经近40 a的研究和改进，WeLink STAR假体设计和非骨水泥固定，使人工踝关节的临床应用具有良好前景。在1999～2004年1月采用STAR型人工踝关节置换治疗骨性踝关节炎、创伤性踝关节炎、局限性距骨缺血坏死和因踝关节痛而行踝关节融合后1例等踝关节病18例，经1~5 a随访(平均3 a 9个月），近期效果良好。 　　1临床资料 　　本组18例中，男13例，女5例；年龄38~67岁，平均477岁。其中骨性踝关节炎6例，创伤性踝关节炎9例，距骨局限性缺血坏死2例，踝关节融合术后1例。所有患者踝关节疼痛跛行，NSaiDs类药物难以缓解17例，踝关节融合术后跗间关节痛和踝部僵硬强直跛行步态不满意而施