基于步态分析法探讨距下关节创伤性关节炎原位植骨融合术疗效

Discussion on the effect of in situ bone grafting and fusion for traumatic arthritis of subtalar joint based on gait analysis

目的探讨原位植骨融合术治疗距下关节创伤性关节炎的临床效果。方法选择2016年3月—2019年3月本院收治的28例距下关节创伤性关节炎患者为试验组,均行原位植骨融合术治疗,再选择健康成人25例为对照组。运用Footscan足底压力分析系统测试两组受试者,并且对比分析重心动态位移曲线和足底峰值压力。结果试验组术后AOFAS评分明显高于术前(P<0.05);试验组患侧第1、2跖骨区域峰值压力明显低于对照组(P<0.05),但是患侧第3~5跖骨区域峰值压力高于对照组(P<0.05);两组足底重心动态位移曲线基本一致,但是与对照组相比,试验组的患侧足底重心不规则外移,而前足触地曲线无内移。结论通过给予距下关节创伤性关节炎患者原位植骨融合术治疗可以获得满意疗效。

Objective To investigate the clinical effect of orthotopic bone graft fusion in the treatment of subtalar traumatic arthritis.Methods From March 2016 to March 2019,28 patients with traumatic arthritis of subtalar joint in our hospital were selected as the experimental group.25 healthy adults were selected as the control group.Two groups of subjects were tested with Footscan plantar pressure analysis system,and the dynamic displacement curve of gravity center and plantar peak pressure were compared and analyzed.Results The AOFAS score of the experimental group was significantly higher than that of the preoperative group(P<0.05).The peak pressure of the first and second metatarsal areas in the experimental group was significantly lower than that in the control group(P<0.05),but the peak pressure of the third and fifth metatarsal areas in the experimental group was higher than that in the control group(P<0.05).The dynamic displacement curve of foot center of gravity of the two groups is basically the same.However,compared with the control group,the center of gravity of the affected foot in the experimental group moved out irregularly,while the curve of the front foot touching the ground did not move in.Conclusion Orthotopic bone grafting for subtalar traumatic arthritis is effective.