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[距骨颈骨折治疗中距骨胫骨关节融合术的疗效。病例回顾与长期随访]

[Arthrodesis of the tarsal tibia for the outcomes in fractures of the collum tali. A review of cases and long-term follow-up].

作者信息

Cantalamessa G, Sallemi G, Mataloni L, Scarfì G

机构信息

I Clinica Ortopedica dell'Università degli Studi di Firenze.

出版信息

Arch Putti Chir Organi Mov. 1990;38(1):49-55.

PMID:2101227
Abstract

In the wards of the CTO Hospital in Florence, isolated arthrodeses of the tarsal tibia for ankle fractures, or their effects or complications, have been performed on 29 patients in the past 13 years. Of these 29 patients we were able to personally check up on 23, with a follow-up time ranging from one to thirteen years. The patients we followed-up on had been operated on using the Scaglietti technique or its variations in 15 cases, the Charnley technique in 7 cases, and the fixation according to Ilizarov in one case. We examined the pre-operatory clinical-radiographic conditions and the surgical techniques utilized with all of their advantages, disadvantages, limits, and pre and post-operatory complications. In the follow-up studies, for instance, in addition to the subjectivity of the patient we clinically evaluated the commemorative signs and post-ambulatory adaptation phenomena as a function of the residual degree of equinism and, radiologically, the condition of the arthrodesis and the articulation proximal to the tarsal tibia. Tibio-tarsal arthrodesis, notwithstanding the inconveniences common to all types of arthrodesis, has in essence retained its validity regarding the seriously crippling effects of ankle fractures.

摘要

在佛罗伦萨CTO医院的病房里,过去13年中对29例患者进行了用于治疗踝关节骨折的距骨胫骨单关节融合术,或其疗效及并发症的相关治疗。在这29例患者中,我们亲自检查了23例,随访时间为1至13年。我们随访的患者中,15例采用斯加利蒂技术或其改良技术进行手术,7例采用查恩利技术,1例采用伊里扎洛夫固定法。我们检查了术前的临床影像学情况以及所采用的手术技术及其所有优点、缺点、局限性以及术前和术后并发症。在随访研究中,例如,除了患者的主观感受外,我们还根据马蹄足残留程度,从临床角度评估了纪念体征和行走后适应现象,并从放射学角度评估了关节融合情况以及距骨胫骨近端关节的状况。尽管所有类型的关节融合术都存在不便之处,但距骨胫骨关节融合术对于踝关节骨折造成的严重致残影响而言,本质上仍具有其有效性。

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