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[1]王勇,張宇,張文舉,等.距舟-舟楔關(guān)節(jié)融合聯(lián)合自體髂骨植骨治療MaceiraⅣ、Ⅴ期Müller-Weiss病[J].中醫(yī)正骨,2022,34(01):73-77.
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距舟-舟楔關(guān)節(jié)融合聯(lián)合自體髂骨植骨治療MaceiraⅣ、Ⅴ期Müller-Weiss病()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年01期
頁(yè)碼:
73-77
欄目:
臨床報(bào)道
出版日期:
2022-01-20

文章信息/Info

作者:
王勇張宇張文舉徐善強(qiáng)李平何凱元
(四川省骨科醫(yī)院,四川 成都 610041)
關(guān)鍵詞:
骨壞死 跗骨 關(guān)節(jié)融合術(shù) 骨移植 Müller-Weiss病
摘要:
目的:觀察距舟-舟楔關(guān)節(jié)融合聯(lián)合自體髂骨植骨治療MaceiraⅣ、Ⅴ期Müller-Weiss病的臨床療效和安全性。方法:2017年1月至2020年1月,采用距舟-舟楔關(guān)節(jié)融合聯(lián)合自體髂骨植骨治療MaceiraⅣ、Ⅴ期Müller-Weiss病患者12例。男2例,女10例; 年齡48~70歲,中位數(shù)58歲; 單足8例,雙足4例; MaceiraⅣ期9例,MaceiraⅤ期3例。所有患者均經(jīng)非手術(shù)治療后效果不佳。術(shù)前行足部CT三維重建及MRI檢查均顯示舟骨外側(cè)完全壓縮、硬化,距舟關(guān)節(jié)及舟楔關(guān)節(jié)均出現(xiàn)關(guān)節(jié)炎改變。病程2~12年,中位數(shù)5年。術(shù)后隨訪觀察關(guān)節(jié)融合、足部畸形矯正、疼痛緩解、患足功能恢復(fù)及并發(fā)癥發(fā)生情況。結(jié)果:所有患者均獲隨訪,隨訪時(shí)間14~42個(gè)月,中位數(shù)23個(gè)月。距舟關(guān)節(jié)和舟楔關(guān)節(jié)均骨性融合,融合時(shí)間12~16周,中位數(shù)12周。距舟覆蓋角,術(shù)前26.4°±2.1°、術(shù)后12個(gè)月6.1°±1.7°; 足正位X線片上距骨第1跖骨角,術(shù)前-11.5°±3.5°、術(shù)后12個(gè)月1.6°±2.1°; 足側(cè)位X線片上距骨第1跖骨角,術(shù)前16.2°±4.5°、術(shù)后12個(gè)月5.3°±1.4°; 足部疼痛視覺(jué)模擬量表評(píng)分,術(shù)前(6.4±1.9)分、術(shù)后12個(gè)月(1.6±0.5)分; 美國(guó)足與踝關(guān)節(jié)協(xié)會(huì)中部足功能評(píng)分,術(shù)前(55.4±4.8)分、術(shù)后12個(gè)月(92.3±4.2)分。1例出現(xiàn)切口感染,行局部清創(chuàng)、植皮后創(chuàng)面愈合,其余患者切口均甲級(jí)愈合; 2例出現(xiàn)足背麻木等癥狀,口服甲鈷胺2個(gè)月后癥狀緩解; 所有患者均未發(fā)生內(nèi)固定松動(dòng)及斷裂。結(jié)論:采用距舟-舟楔關(guān)節(jié)融合聯(lián)合自體髂骨植骨治療MaceiraⅣ、Ⅴ期Müller-Weiss病,能矯正足部畸形、緩解足部疼痛、促進(jìn)足部功能的恢復(fù),且關(guān)節(jié)融合率較高、并發(fā)癥較少。

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備注/Memo

備注/Memo:
基金項(xiàng)目:四川省干部保健科研課題項(xiàng)目(川干研2021-606)
通訊作者:張宇 E-mail:[email protected]
更新日期/Last Update: 1900-01-01