Schwarz R J, Macdonald M R C, van der Pas M
Green Pastures Hospital and Rehabilitation Centre, Box 28, Pokhara, Nepal.
J Bone Joint Surg Br. 2006 Jun;88(6):747-50. doi: 10.1302/0301-620X.88B6.17276.
We describe the results of arthrodesis for the treatment of recurrent acute neuropathic bone disease in 24 feet and of chronic disease with deformity in 91 feet, undertaken between January 1984 and December 2003. All were due to leprosy. Correction of the deformity was achieved in 80 of 106 feet (76%) and fusion in 97 of 110 feet (88%). In the 24 feet in which recurrent neuropathic bone disease was the reason for surgery, 17 (71%) obtained stability while in seven (29%) symptoms recurred postoperatively. Complications were experienced following 58 of the 110 operations (53%). In patients presenting primarily with deformity with a minimum follow-up of two years (79 feet), there was a reduced frequency of ulceration in 40 (51%). Normal footwear could be worn by 32 patients (40%) after surgery, while 40 (51%) required a moulded insole. Arthrodesis of the ankle in the neuropathic foot due to leprosy has a good overall rate of success although the rate of complications is high.
我们描述了1984年1月至2003年12月期间对24只足的复发性急性神经性骨病以及91只足的伴有畸形的慢性疾病进行关节融合术的治疗结果。所有病例均由麻风病引起。106只足中有80只（76%）畸形得到矫正，110只足中有97只（88%）实现融合。在因复发性神经性骨病而接受手术的24只足中，17只（71%）获得了稳定性，7只（29%）术后症状复发。110例手术中有58例（53%）出现了并发症。在主要表现为畸形且随访至少两年的患者（79只足）中，40只（51%）溃疡发生频率降低。术后32例患者（40%）可以穿正常鞋子，40例（51%）需要定制鞋垫。尽管并发症发生率较高，但麻风病所致神经性足踝的关节融合术总体成功率良好。
