螺钉固定踝关节融合术失败后钢板再固定疗效观察

摘要

Objective:To observe the therapeutic effects of steel plate fixation after the failure of arthrodesis of ankle by screw fixation. Methods: From August 2001 to October 2011,15 patients were with steel plate fixation after failure of arthrodesis of ankle by screw fixation. Among patients,9 cases were males and 6 cases were females,ranging age from 40 to 65 years old with the average of 56 years old. Ten cases were in left and 5 cases were in right. Screws were removed and steel plate was fixed intraoperatively, and plaster external fixation for postoperation. Clincal effect were evaluated according to AOFAS scoring system from pain, waliking ability and aligment before and after operation, and X-ray was used to evaluate joint fusion after operation. Results: All patients were followed up,and the duration ranged from 4 months to 4 years with an average of 2 years. The incison were healed in stage I. No ankle pain,injury of blood vessel and nerve,infection and farilure of internal fixation occuerred. The AOFAS score increased from 36.86±8.32 preoperatively to 85.09±4.65 (t=-26.366,P=0.000). Conclusion: Steel plate fixation after the failure of ankle arthrodesis of screw fixation has the advantages of rigid stability, simple manipulation and high success rate, less pain, perfect recovery.%目的:观察螺钉固定踝关节融合术失败后钢板固定的临床疗效.方法:自2001年8月至2011年10月对15例螺钉固定踝关节融合失败后的患者行钢板固定,其中男9例,女6例；年龄40～65岁,平均56岁；左足10例,右足5例.术中螺钉予以拆除,行钢板固定,术后予石膏外固定.采用AOFAS评分系统从疼痛、行走功能、踝关节对线等方面比较术前与末次随访AOFAS计分,X线片评估术后融合情况.结果:15例均获随访,时间4个月～4年,平均2年.切口均Ⅰ期愈合.踝关节无疼痛,无神经血管损伤,无感染和内固定失败等并发症.术后AOFAS评分中客观项目均较术前改善,总分由术前的(36.86±8.32)分提高到术后的(85.09±4.65)分(t=-26.366,P=0.000).结论:螺钉固定踝关节融合失败后钢板固定稳定性好,操作简单,成功率高,踝关节疼痛明显减轻,功能恢复良好.