Tellisi Nazzar, Fragomen Austin T, Kleinman Dawn, O'Malley Martin J, Rozbruch S Robert
Hospital for Special Surgery, Limb Lengthening and Deformity Service, Foot and Ankle Service, 535 East 70th Street, New York, NY 10021, USA.
Foot Ankle Int. 2009 Apr;30(4):318-25. doi: 10.3113/FAI.2009.0318.
In recent years ankle distraction arthroplasty has gained popularity in the treatment of ankle arthritis as a means of both maintaining range of motion and avoiding fusion. We present a retrospective review of 25 patients who have undergone ankle distraction from 1999 to 2006.
The mean age was 43 years; 16 were male, and 7 were female. Followup was 30 months after frame removal (range, 12 to 60 months). We were able to obtain followup on 23 of 25 patients. Adjuvant procedures were performed in some cases including Achilles tendon lengthening (5), ankle arthroscopy (4), open arthrotomy (1), and supramalleolar tibial and distal fibular osteotomy to correct distal tibial deformity (6).
Twenty-one patients (91%) reported improved pain with those furthest post-op experiencing the best results. The average preoperative AOFAS score was 55 (range, 29 to 82), and the average postoperative score was 74 (range, 47 to 96). The difference between pre- and postoperative scores was significant (p = 0.005). SF-36 scores showed modest improvement in all components. Only two of the patients in the study underwent fusion after ankle distraction. Total ankle motion was maintained in all patients with improvement in the functional arc of motion in five patients who started with mild equinus contractures.
We feel that ankle distraction offers a promising solution for many people with ankle arthritis.
近年来，踝关节撑开成形术作为一种维持活动范围并避免融合的方法，在踝关节关节炎的治疗中越来越受欢迎。我们对1999年至2006年间接受踝关节撑开手术的25例患者进行了回顾性研究。
患者平均年龄43岁；男性16例，女性7例。在去除外固定架后30个月（范围12至60个月）进行随访。25例患者中有23例获得随访。部分病例还进行了辅助手术，包括跟腱延长术（5例）、踝关节镜检查（4例）、切开手术（1例）以及为纠正胫骨远端畸形而进行的胫骨髁上和腓骨远端截骨术（6例）。
21例患者（91%）报告疼痛改善，术后时间最长的患者效果最佳。术前美国足踝外科协会（AOFAS）评分平均为55分（范围29至82分），术后平均评分为74分（范围47至96分）。术前和术后评分差异有统计学意义（p = 0.005）。SF - 36评分在所有方面均有适度改善。研究中只有2例患者在踝关节撑开术后进行了关节融合。所有患者的踝关节活动度均得以维持，5例最初有轻度马蹄足挛缩的患者其功能活动弧度有所改善。
我们认为踝关节撑开术为许多踝关节关节炎患者提供了一个有前景的治疗方案。
