Ilizarov技术联合跟腱延长治疗踝关节再植术后关节僵硬、跟腱挛缩8例分析

Ilizarov technique combined with Achilles tendon extension for the treatment of ankle joint stiffness and Achilles contracture in 8 cases

目的观察Ilizarov外固定架牵张技术联合跟腱延长治疗踝关节离断再植术后踝关节僵硬、跟腱挛缩的效果。方法选取2013年6月—2016年6月踝关节离断再植术后踝关节僵硬、跟腱挛缩8例,均采用Ilizarov外固定架牵张技术+跟腱延长治疗。拆除Ilizarov外固定架后,观察患者症状改善情况,并评估踝关节活动度改变。结果 8例患者均获随访,随访时间6~18个月。术后踝关节活动度均得到有效恢复,患者可用足跟行走,马蹄足畸形消失,行走时踝关节无疼痛,但踝关节间隙未见明显改变。结论 Ilizarov技术联合跟腱延长治疗踝关节离断再植术后踝关节僵硬、跟腱挛缩经康复锻炼无效者,可改善临床症状、恢复踝关节活动度。

Objective To observe the clinical efficacy of Ilizarov technique combined with Achilles tendon lengthening treatment of ankle joint stiffness and contracture of Achilles tendon after replantation. Methods From June 2013 to June 2016,in our department, there were 8 patients with ankle joint stiffness and contracture of Achilles tendon after replantation treated with Ilizarov apparatus and Achilles tendon lengthening. The evaluation was done with the Range of Motion （ROM） after removing the external fixture. Results All the 8 patients were followed up from 6 to 18 months, mean 11 months.Range of Motion （ROM） was effectively restored after the follow-up. The difference was statistically significant（P〈0.05）. After the operation, the ankle joint mobility was recovered effectively, the heel of the patient could be walked, the clubfoot deformity disappeared, the ankle joint did not have pain when walking, but there was no obvious change in ankle joint space. Conclusion Ankle joint stiffness, contracture of Achilles tendon, ineffective rehabilitation exercises of the patients who had replantation of severed ankle. Range of Motion （ROM） was effectively restored with Ilizarov technique combined with Achilles tendon lengthening treatment. Ilizarov technique combined with Achilles tendon extension treatment of ankle replantation after ankle stiffness, Achilles tendon contracture by rehabilitation exercise is invalid, can improve clinical symptoms and restore ankle activity.