人工踝关节置换：43例5年5个月随访结果

Total ankle replacement： the long-term results of 43 ankles

目的研究人工踝关节置换治疗踝关节病损的疗效。方法1997年10月～2006年3月人工踝关节置换治疗43例踝关节病损，包括踝关节骨关节炎22例，创伤性踝关节炎21例。其中2例为距骨局限性坏死，1例为胫骨骨折并骨筋膜室综合征行广泛切除踝关节融合术后。结果43例随访2年。8年4个月，平均5年5个月。踝关节功能采用Kofoed评价标准和作者自定评价方法进行分析：优（85～100分）32例，良（75～84分）9例，差（60～74分）2例，无失败（〈60分）患者，优良率为95．3％。踝关节功能情况：足背伸6°～16°，跖屈8°～28°；足背伸和跖屈的活动范围14°～38°，平均21．4°。3例出现切口缘皮肤坏死，术中内外踝骨折1例。无足内翻、足外翻和假体影像学松动患者。结论人工踝关节置换是改善踝关节功能的良好方法。

Objective To study the therapeutic results of total ankle replacement in treatment of ankle disorders. Methods From October 1997 to March 2006, total ankle replacement was employed to treat 22 cases of ankle osteoarthritis and 21 ones of traumatic arthritis, 2 of which resulted from local necrosis of the talus and one occurred after ankle arthrodesis for tibial fracture and osteofascial compartment syndrome. Results Their follow-ups averaged 5 years and 5 months （2 to 8 years and 4 months） . The ankle functions evaluated by Kofoed＇s system and the authors＇ system were excellent （85-100） in 32 ankles, good （75-84） in 9, and poor （60-74） in 2, and disabled（ 〈 60） in none. The foot dorsiflexion was 6°-16° and plantar flexion 8°-28°. The movement of the foot dorsiflexion and plantar flexion ranged from 14° to 38° （average, 21.4°） . The complications were the skin necrosis of incision border in 3 cases and intraoperative fracture of both malleoli in 1 case. No foot inversion, eversion or radiographic loosening was seen. Conclusion Total ankle replacement is a good method for improvement of the ankle function.