踝上截骨与踝关节融合术应用于创伤性踝关节炎治疗的临床效果研究

Clinical Effect of Supramalleolar Osteotomy and Ankle Arthrodesis in the Treatment of Traumatic Ankle Arthritis

目的 研究创伤性踝关节炎应用踝上截骨治疗法和踝关节融合术治疗法的效果。方法 选取2018年3月-2021年3月青海省西宁市第三人民医院收治30例创伤性踝关节炎患者作为研究对象,按照不同治疗方法分组,接受踝上截骨治疗法的15例作为对照组,接受踝关节融合术治疗法的15例作为观察组,均实施为期1年的随访,回顾病案,统计并对比两组愈合情况、踝关节功能恢复情况、疼痛情况。结果 观察组与对照组的骨性愈合率、骨性愈合时间、治疗前/后AOFAS评分、治疗前/后的VAS评分等差异无统计学意义(P>0.05);观察组与对照组治疗后的AOFAS评分均较治疗前有明显的提升,VAS评分皆较治疗前有明显的减少,差异有统计学意义(P <0.05);两组治疗前的生活质量评分对比差异无统计学意义(P>0.05),治疗后两组评分对比观察组高于对照组,差异有统计学意义(P <0.05)。结论 创伤性踝关节炎临床治疗中踝上截骨疗法、踝关节融合术皆可辅助患者获得骨性愈合,两种治疗方案在愈合时间、术后疼痛、关节功能等指标方面无明显差异。

Objective To study the effect of supramalleolar osteotomy and ankle arthrodesis in the treatment of traumatic ankle arthritis. Methods A total of 30 patients with traumatic ankle arthritis who were admitted to the hospital from March 2018 to March 2021 were selected as the research objects,and were grouped according to different treatment methods. Fifteen patients who received supra-ankle osteotomy were selected as the control group, and 15 patients who received ankle joint fusion were selected as the observation group. All patients were followed up for one year to review the medical records, and the healing, ankle function recovery and pain of the two groups were compared. Results There was no statistically significant difference between the observation group and the control group in bone healing rate, bone healing time, AOFAS score before/after treatment, and VAS score before/after treatment(P > 0.05). The difference between the observation group and the control group after treatment AOFAS scores were significantly improved compared to before treatment, and VAS scores were significantly reduced compared to before treatment, and the difference was statistically significant(P <0.05). The comparison of the quality of life scores between the two groups before treatment was not statistically significant(P >0.05). After treatment, the scores of the two groups in the observation group were higher than those in the control group, and the difference was statistically significant(P < 0.05).Conclusion In the clinical treatment of traumatic ankle arthritis, supraankle osteotomy and ankle fusion can assist patients to achieve bone healing. There is no significant difference between the two treatment schemes in healing time, postoperative pain and joint function.