可调式踝关节牵引固定架在矫形外科临床应用.docVIP

可调式踝关节牵引固定架在矫形外科临床应用 　 作者：崔树科,王鑫,崔海文,郭俊林 【关键词】 踝关节 　　摘 要：［目的］探讨可调式踝关节牵引固定架在矫形外科的临床应用及疗效。［方法］自1999年1月～2005年5月，手术治疗马蹄内翻足畸形45例55足，手术治疗后分别行可调式踝关节牵引固定(A组，n=26例，32足)和石膏外固定(B组，n=19例，23足)。随访比较2组关节矫形疗效和踝关节功能评分，并进行样本t检验或x2检验进行统计学比较。［结果］38例患者获得有效随访。就踝关节功能评分和矫形手术疗效进行统计分析，2组间有统计学差异。［结论］本固定架控制踝关节位置准确，可促进踝关节融合，后期踝关节功能恢复满意。 　　关键词：踝关节； 外固定架； 创伤； 矫形； 足下垂 　　Application and clinical results of the adjustable erternal fixation of ankle joint in orthopedic surgery 　　　Abstract：［Objective］To study the application and clinical results of the adjustable erternal fixation of ankle joint (AEFA) in orthopedic surgery.［Method］From January 1999 to May 2005, 45 cases (55 feet)of equinovarus deformity were treated with orthopedic surgery. In order to preventent the deformity relapsion,the patients were assigned to two groups. The A group (26 cases, 32 feet )patients were treated with the adjustable erternal fixation of ankle joint(AEFA). The B group(19 cases, 23 feet)patients were treated with plaster immobilization. The orthopedic surgery effect and functions of ankle joint were studied and tested with independent sample t test and x2 test.［Result］Thirtyeight cases were fellowedup for 3 months to 9 years(averaged 19 months).There were significant difference between the two groups in the functions of ankle joint.［Conclusion］The new apparatus can effectively prevent the footdrop deformity and enhance the function of ankle joint. 　　Key words:Ankle joint; External fixation apparatus; Trauma; Orthopedic; Footdrop 　　多种先天或后天疾病可导致马蹄内翻足畸形，严重时患者前足着地影响行走功能。为矫正畸形缓解疼痛，恢复踝关节功能，常需行踝关节松解、肌力平衡、踝关节融合等各种矫形手术。此类手术，术后能否将踝关节固定维持在功能位，预防畸形复发是手术成败的关键点。本科自1999年起将可调式踝关节牵引固定架应用于矫形外科，临床效果满意，现报告如下。 　　1 临床资料与方法 　　11 可调式踝关节牵引固定架的基本构型 AEFA的基本结构由5部分组成：胫骨结节牵引弓、跖骨牵引弓、中间可调节长度的调节杆及调节杆两端与弓连接的2个球型可锁定装置。调整与锁定：两弓均有旋转和内外翻各15°的调节范围，通过胫骨结节牵引针和跖骨牵引针将小腿和踝关节连为三角形，调节中间的调节杆使踝关节固定在所需角度；调节跖骨牵引弓上的球型关节可调整踝关节的内外翻角度。(见图1) 　　12 临床资料 　　45例患者中，男29例，女16例；年龄16～43岁，平均285岁。致畸原因：先天性畸形6例；麻痹性12例；痉挛性6例；创伤性21例。行矫形手术类型：踝关节松解术19例；肌腱转位术13例；跟腱延长术12例；踝关节融合术11例。为预防术后下垂