Post-traumatic osteoarthritis(PTOA)is a complex and painful problem in the foot and ankle.Ninety percent of osteoarthritis cases in the foot and ankle can be classified as post-traumatic.PTOA can affect any of the 33 ...Post-traumatic osteoarthritis(PTOA)is a complex and painful problem in the foot and ankle.Ninety percent of osteoarthritis cases in the foot and ankle can be classified as post-traumatic.PTOA can affect any of the 33 joints in the foot and the ankle.Distraction arthroplasty is a method for treatment of early arthritic joints without fusing or replacing them and its effectiveness has been well documented.The purpose of this case series is to present our successful experiences and positive results using distraction arthroplasty to treat PTOA in the ankle,subtalar,first metatarsophalangeal,and second tarsometatarsal joints,and to present distraction arthroplasty as a viable alternative to invasive joint sacrificing procedures such as arthrodesis or arthroplasty.Distraction Arthroplasty effectively and safely treats PTOA and improves the stability of joints in the Foot and Ankle.Additionally,the use of bone marrow aspirate concentrate as an adjuvant can improve the long-term functional and structural outcomes of the joint,and can prolong the need for further,more aggressive surgical interventions such as fusion or arthroplasty.展开更多
Objective:To analyze and explore the clinical value of arthroscopy in traumatic sports ankle arthritis.Methods:The study period was from June 2016 to June 2020.A selected sample of 25 patients with traumatic sports an...Objective:To analyze and explore the clinical value of arthroscopy in traumatic sports ankle arthritis.Methods:The study period was from June 2016 to June 2020.A selected sample of 25 patients with traumatic sports ankle arthritis in Qingyang People's Hospital were treated.All patients underwent arthroscopy and the specific treatment effects were analyzed.Results:Comparing the preoperative and postoperative ankle-hindfoot scores,the distance of talus advancement,modified Mcguire's ankle scoring system,and visual analog scale(VAS)pain scores,the postoperative results were significantly better than those of the preoperative(P<0.05).Conclusion:Arthroscopy in traumatic sports ankle arthritis has a significant effect,with minor trauma and rapid postoperative recovery which improves various discomfort symptoms.It is worthy of promotion and application.展开更多
Ankle fractures are one of the most common injuries treated by orthopaedic surgeons. A minority of patients with ankle fractures go on to develop persistent pain following anatomical reduction. These sequelae may aris...Ankle fractures are one of the most common injuries treated by orthopaedic surgeons. A minority of patients with ankle fractures go on to develop persistent pain following anatomical reduction. These sequelae may arise as a result of untreated ligamentous or chondral injuries. This study aims to correlate acute arthroscopic ankle findings with the <i><span>Lauge-Hansen </span></i><span>fracture pattern classification. We further aim to compare subjective functional outcomes at least one year following surgery between patients who have received Open Reduction and Internal Fixation (ORIF) alone, </span><b><i><span>versus</span></i></b><i><span> </span></i><span>ORIF </span><i><span>plus</span></i><span> arthroscopy. This is a retrospective case series of patients who have undergone ankle fracture ORIF +/</span><span>-</span><span> arthroscopy from July 2014 to July 2017 inclusive. Each patient’s presenting radiograph was classified according to the </span><i><span>Lauge-Hansen</span></i><span> ankle fracture classification with subsequent correlation to intra-operative arthroscopic findings. Functional outcome at a minimum of one year was evaluated with the American Academy of Orthopaedic Surgeons (AAOS) metric. Twenty two patients underwent ankle ORIF plus arthroscopy (Group A) with a further 26 patients receiving ORIF alone (Group B). 1 in 3 supination-external-rotation type II (SER II) injuries possessed a concomitant syndesmosis injury or osteochondral lesion (OCL) on arthroscopy. 1 in 3 patients with a</span><span>n</span><span> SER IV injury had an osteochondral lesion. The mean AAOS score achieved for Group A was 89.6 (±7.9) with the mean score for Group B being 82.0 (±13.7). In conclusion, ankle arthroscopy aids the diagnosis and treatment of ligamentous and osteochondral injuries not evident on plain film with subsequent superior short-term outcomes</span><span>.</span>展开更多
目的:探讨影响踝关节骨折患者术后创伤性关节炎的危险因素,并构建风险预测模型。方法:选取2020年5月至2022年5月治疗的550例踝关节骨折患者为研究对象,按照7∶3分为建模组(385例)和验证组(165例),建模组根据术后是否发生创伤性关节炎将...目的:探讨影响踝关节骨折患者术后创伤性关节炎的危险因素,并构建风险预测模型。方法:选取2020年5月至2022年5月治疗的550例踝关节骨折患者为研究对象,按照7∶3分为建模组(385例)和验证组(165例),建模组根据术后是否发生创伤性关节炎将患者作为发生组(112例)和未发生组(273例)。记录患者的年龄、身体质量指数(body mass index,BMI)、性别、吸烟史、糖尿病史、致伤原因、骨折类型、手术时机、体力劳动、开放性损伤、骨质疏松、复位不良、术后负重时间、血管损伤、手术方式等信息;采用单因素和多因素Logistic回归分析影响踝关节骨折患者术后发生创伤性关节炎的危险因素;采用R软件建立构建列线图预测模型;采用受试者工作特征(receiver operating characteristic,ROC)曲线、校准图形验证模型的区分度以及一致性。结果:建模组112例出现术后创伤性关节炎,273例未发生。单因素分析结果显示,发生组和未发生组年龄、BMI、骨折类型、手术时机、体力劳动>Ⅱ级、开放性损伤、骨质疏松、复位不良例数比较,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示年龄(OR=2.887)、BMI(OR=4.042)、骨折类型(OR=4.244)、手术时机(OR=2.665)、体力劳动>Ⅱ级(OR=5.099)、骨质疏松(OR=10.219)、复位不良(OR=3.112)均为影响踝关节骨折患者术后创伤性关节炎的独立危险因素(P<0.05)。基于以上危险因素建立预测踝关节骨折患者术后创伤性关节炎发生风险的列线图模型,并进行内外部验证,结果显示建模组和验证组校准曲线显示校正曲线和理想曲线拟合度均较好,表明模型预测术后创伤性关节炎发生风险与实际发生风险基本一致;ROC曲线下面积分析结果显示分别为0.867[95%CI(0.826,0.908)]、0.882[95%CI(0.827,0.938)],表明预测模型具有良好的预测能力。结论:年龄、BMI、骨折类型、手术时机、体力劳动>Ⅱ级、骨质疏松、复位不良均为影响踝关节骨折患者术后创伤性关节炎的危险因素,基于以上危险因素构建的预测模型可有效评估踝关节骨折患者术后创伤性关节炎的发生风险。展开更多
目的 分析模拟仿真功能评估训练系统(BTE Primus RS)对踝关节创伤性关节炎患者三维步态参数的影响。方法 收集2019年12月至2021年12月宝鸡市中医医院康复医学科收治的96例踝关节创伤性关节炎患者,根据电脑数字表法进行随机分组,对照组4...目的 分析模拟仿真功能评估训练系统(BTE Primus RS)对踝关节创伤性关节炎患者三维步态参数的影响。方法 收集2019年12月至2021年12月宝鸡市中医医院康复医学科收治的96例踝关节创伤性关节炎患者,根据电脑数字表法进行随机分组,对照组48例予以常规训练,观察组48例予以BTE Primus RS训练,比较2组患者的干预效果、关节活动度、三维步态参数及无痛步行距离。结果 训练后,观察组患者的总优良率是93.8%,高于对照组的79.2%(P<0.05);观察组患者踝关节的外翻、背伸、外展、跖屈及内收角度均高于对照组(P<0.05);观察组患者患足廓清地面的最大距离、步长均长于对照组,同时步频与步速也高于对照组(P<0.05);观察组中无痛步行200~500 m及>500 m的患者数高于对照组,而无痛步行距离<200 m的患者数则低于对照组(P<0.05)。结论 BTE Primus RS训练在踝关节创伤性关节炎患者中的应用效果显著,有助于提升其干预效果,改善关节活动度与三维步态参数,并且促进无痛步行距离延长。展开更多
目的观察关节镜手术治疗踝关节骨折后创伤性关节炎的近期效果。方法 2007年12月～2009年4月我院对17例踝关节骨折术后创伤性关节炎进行踝关节镜手术治疗,并运用关节镜观察踝关节病变情况。结果术中踝关节镜下见慢性滑膜炎性增生17例,胫...目的观察关节镜手术治疗踝关节骨折后创伤性关节炎的近期效果。方法 2007年12月～2009年4月我院对17例踝关节骨折术后创伤性关节炎进行踝关节镜手术治疗,并运用关节镜观察踝关节病变情况。结果术中踝关节镜下见慢性滑膜炎性增生17例,胫骨下端前缘骨赘6例,距骨颈部骨赘4例,距骨关节软骨损伤11例,胫骨关节软骨损伤4例,游离体2例。术后48 h 5例有关节疼痛、轻度肿胀1,周后好转,余无明显关节疼痛。16例随访12～25个月,平均18.2个月。根据Baird等踝关节评分系统评定疗效,优4例,良10例,可2例,优良率87.5%。结论踝关节镜手术治疗踝关节骨折后创伤性关节炎近期效果满意。展开更多
文摘Post-traumatic osteoarthritis(PTOA)is a complex and painful problem in the foot and ankle.Ninety percent of osteoarthritis cases in the foot and ankle can be classified as post-traumatic.PTOA can affect any of the 33 joints in the foot and the ankle.Distraction arthroplasty is a method for treatment of early arthritic joints without fusing or replacing them and its effectiveness has been well documented.The purpose of this case series is to present our successful experiences and positive results using distraction arthroplasty to treat PTOA in the ankle,subtalar,first metatarsophalangeal,and second tarsometatarsal joints,and to present distraction arthroplasty as a viable alternative to invasive joint sacrificing procedures such as arthrodesis or arthroplasty.Distraction Arthroplasty effectively and safely treats PTOA and improves the stability of joints in the Foot and Ankle.Additionally,the use of bone marrow aspirate concentrate as an adjuvant can improve the long-term functional and structural outcomes of the joint,and can prolong the need for further,more aggressive surgical interventions such as fusion or arthroplasty.
文摘Objective:To analyze and explore the clinical value of arthroscopy in traumatic sports ankle arthritis.Methods:The study period was from June 2016 to June 2020.A selected sample of 25 patients with traumatic sports ankle arthritis in Qingyang People's Hospital were treated.All patients underwent arthroscopy and the specific treatment effects were analyzed.Results:Comparing the preoperative and postoperative ankle-hindfoot scores,the distance of talus advancement,modified Mcguire's ankle scoring system,and visual analog scale(VAS)pain scores,the postoperative results were significantly better than those of the preoperative(P<0.05).Conclusion:Arthroscopy in traumatic sports ankle arthritis has a significant effect,with minor trauma and rapid postoperative recovery which improves various discomfort symptoms.It is worthy of promotion and application.
文摘Ankle fractures are one of the most common injuries treated by orthopaedic surgeons. A minority of patients with ankle fractures go on to develop persistent pain following anatomical reduction. These sequelae may arise as a result of untreated ligamentous or chondral injuries. This study aims to correlate acute arthroscopic ankle findings with the <i><span>Lauge-Hansen </span></i><span>fracture pattern classification. We further aim to compare subjective functional outcomes at least one year following surgery between patients who have received Open Reduction and Internal Fixation (ORIF) alone, </span><b><i><span>versus</span></i></b><i><span> </span></i><span>ORIF </span><i><span>plus</span></i><span> arthroscopy. This is a retrospective case series of patients who have undergone ankle fracture ORIF +/</span><span>-</span><span> arthroscopy from July 2014 to July 2017 inclusive. Each patient’s presenting radiograph was classified according to the </span><i><span>Lauge-Hansen</span></i><span> ankle fracture classification with subsequent correlation to intra-operative arthroscopic findings. Functional outcome at a minimum of one year was evaluated with the American Academy of Orthopaedic Surgeons (AAOS) metric. Twenty two patients underwent ankle ORIF plus arthroscopy (Group A) with a further 26 patients receiving ORIF alone (Group B). 1 in 3 supination-external-rotation type II (SER II) injuries possessed a concomitant syndesmosis injury or osteochondral lesion (OCL) on arthroscopy. 1 in 3 patients with a</span><span>n</span><span> SER IV injury had an osteochondral lesion. The mean AAOS score achieved for Group A was 89.6 (±7.9) with the mean score for Group B being 82.0 (±13.7). In conclusion, ankle arthroscopy aids the diagnosis and treatment of ligamentous and osteochondral injuries not evident on plain film with subsequent superior short-term outcomes</span><span>.</span>
文摘目的:探讨影响踝关节骨折患者术后创伤性关节炎的危险因素,并构建风险预测模型。方法:选取2020年5月至2022年5月治疗的550例踝关节骨折患者为研究对象,按照7∶3分为建模组(385例)和验证组(165例),建模组根据术后是否发生创伤性关节炎将患者作为发生组(112例)和未发生组(273例)。记录患者的年龄、身体质量指数(body mass index,BMI)、性别、吸烟史、糖尿病史、致伤原因、骨折类型、手术时机、体力劳动、开放性损伤、骨质疏松、复位不良、术后负重时间、血管损伤、手术方式等信息;采用单因素和多因素Logistic回归分析影响踝关节骨折患者术后发生创伤性关节炎的危险因素;采用R软件建立构建列线图预测模型;采用受试者工作特征(receiver operating characteristic,ROC)曲线、校准图形验证模型的区分度以及一致性。结果:建模组112例出现术后创伤性关节炎,273例未发生。单因素分析结果显示,发生组和未发生组年龄、BMI、骨折类型、手术时机、体力劳动>Ⅱ级、开放性损伤、骨质疏松、复位不良例数比较,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示年龄(OR=2.887)、BMI(OR=4.042)、骨折类型(OR=4.244)、手术时机(OR=2.665)、体力劳动>Ⅱ级(OR=5.099)、骨质疏松(OR=10.219)、复位不良(OR=3.112)均为影响踝关节骨折患者术后创伤性关节炎的独立危险因素(P<0.05)。基于以上危险因素建立预测踝关节骨折患者术后创伤性关节炎发生风险的列线图模型,并进行内外部验证,结果显示建模组和验证组校准曲线显示校正曲线和理想曲线拟合度均较好,表明模型预测术后创伤性关节炎发生风险与实际发生风险基本一致;ROC曲线下面积分析结果显示分别为0.867[95%CI(0.826,0.908)]、0.882[95%CI(0.827,0.938)],表明预测模型具有良好的预测能力。结论:年龄、BMI、骨折类型、手术时机、体力劳动>Ⅱ级、骨质疏松、复位不良均为影响踝关节骨折患者术后创伤性关节炎的危险因素,基于以上危险因素构建的预测模型可有效评估踝关节骨折患者术后创伤性关节炎的发生风险。
文摘目的 分析模拟仿真功能评估训练系统(BTE Primus RS)对踝关节创伤性关节炎患者三维步态参数的影响。方法 收集2019年12月至2021年12月宝鸡市中医医院康复医学科收治的96例踝关节创伤性关节炎患者,根据电脑数字表法进行随机分组,对照组48例予以常规训练,观察组48例予以BTE Primus RS训练,比较2组患者的干预效果、关节活动度、三维步态参数及无痛步行距离。结果 训练后,观察组患者的总优良率是93.8%,高于对照组的79.2%(P<0.05);观察组患者踝关节的外翻、背伸、外展、跖屈及内收角度均高于对照组(P<0.05);观察组患者患足廓清地面的最大距离、步长均长于对照组,同时步频与步速也高于对照组(P<0.05);观察组中无痛步行200~500 m及>500 m的患者数高于对照组,而无痛步行距离<200 m的患者数则低于对照组(P<0.05)。结论 BTE Primus RS训练在踝关节创伤性关节炎患者中的应用效果显著,有助于提升其干预效果,改善关节活动度与三维步态参数,并且促进无痛步行距离延长。
文摘目的观察关节镜手术治疗踝关节骨折后创伤性关节炎的近期效果。方法 2007年12月～2009年4月我院对17例踝关节骨折术后创伤性关节炎进行踝关节镜手术治疗,并运用关节镜观察踝关节病变情况。结果术中踝关节镜下见慢性滑膜炎性增生17例,胫骨下端前缘骨赘6例,距骨颈部骨赘4例,距骨关节软骨损伤11例,胫骨关节软骨损伤4例,游离体2例。术后48 h 5例有关节疼痛、轻度肿胀1,周后好转,余无明显关节疼痛。16例随访12～25个月,平均18.2个月。根据Baird等踝关节评分系统评定疗效,优4例,良10例,可2例,优良率87.5%。结论踝关节镜手术治疗踝关节骨折后创伤性关节炎近期效果满意。
