enblock切除术联合结构性植骨治疗第1跖趾关节痛风性关节炎 word格式.docxVIP

En-block 切除术联合结构性植骨治疗第 1 跖趾关节痛风性关节炎中文摘要En-block 切除术联合结构性植骨治疗第 1 跖趾关节痛风性关节炎 中文摘要目的探讨采用 En-block 切除术结合结构性植骨关节融合治疗第 1 跖趾关节痛风性关 节炎的手术技术及疗效。方法2012 年6 月至2013 年10 月，我院共收治9 例第1 跖趾关节痛风性关节炎患 者。男8 例，女1 例，年龄25~68 岁，平均47 岁。所有患者均采用En-block 病灶切 除结合结构性植骨第1 跖趾关节融合术。术后定期复查，摄片明确愈合情况，并采用 美国骨科足踝外科协会（American Orthopaedic Foot and Ankle Society，AOFAS）前 足评分及疼痛直观模拟量表（visual analogue scale，VAS）评价治疗效果，记录相关 并发症。结果 所有患者伤口均一期愈合，未见伤口感染、皮肤坏死等软组织并发症。术后8 例患者获得12~24 个月随访，平均17.3 个月。影像学检查明确术后平均10 周融合端 骨性愈合。AOFAS 评分从术前平均（44.3±9.7）分提高至术后（79.4±10.1）分，而 VAS评分从术前平均（7.0±1.9）分降至术后（1.1±0.6）分，其差异均有统计学意义（P＜0.0001）。随访期间未见骨不连、畸形愈合及固定失效等并发症。结论En-block 切除结合结构性植骨融合治疗第1跖趾关节痛风性关节炎具有症状缓解明显、融合率 高、并发症少等优势，可有效改善患者生活质量，是一种安全有效的治疗方式。 关键词En-block切除；第1跖趾关节；痛风性关节炎；关节融合术；植骨作者：宋国勋 指导老师：施忠民英文摘要En-block 切除术联合结构性植骨治疗第 1 跖趾关节痛风性关节炎 Treatment of first metatarsophalangeal joint gouty arthritis by arthrodesis with En-block resection and structural bone graftAbstractObjective: To investigate the technique and clinical outcome of arthrodesis with En-block resection and structural bone graft to treat the 1st MTPJ gouty arthritis.Methods: From June 2012 to October 2013, 9 patients suffering from 1st MTPJ gouty arthritis were treated in our hospital. There were 8 men and 1 woman with an average age of 47 years (range 25-68 years). The first MTPJ arthrodesis with En-block resection and structural bone graft was performed in all patients. X-rays were taken in regular follow-up to confirm the fusion union. Overall functional evaluation was carried out according to visual analogue scale (VAS) and the forefoot score of American Orthopaedic Foot and Ankle Society (AOFAS) at the last follow-up. Complications were also recorded.Results: All wounds were healed without any soft tissue complications of infection or skin necrosis. Eight patients got the final follow-up of an average 17.3 months (range 12-24 months). X-ray demonstrated the bone union of fusion 10 weeks postoperatively on average. AOFAS score was improved from