Department of Orthopaedic Surgery, University of Regensburg, Bad Abbach, Germany.
Int Orthop. 2012 Dec;36(12):2491-4. doi: 10.1007/s00264-012-1670-y. Epub 2012 Oct 6.
The talonavicular joint is a central connection of the human foot. Symptomatic talonavicular arthritis can be adequately addressed by isolated talonavicular fusion. However, non-union remains a relevant clinical challenge to the orthopaedic surgeon. The aim of this study was to analyse the clinicoradiological outcome of talonavicular fusion using angle-stable mini-plates.
We performed 30 talonavicular fusions in 30 patients (12 male, 18 female) with a mean age of 58.8 years (range, 22-74) between 2005 and 2007. Osseous joint fusion was achieved using mono- and multidirectional angle-stable mini-plates. The patients followed a standardised immobilisation and weight bearing protocol. The mean postoperative follow up was 15.8 months (6.1-23.8).
The American Orthopedic Foot and Ankle Society AOFAS score increased significantly from 31.7 (19-42) to 82.3 points (55-97) (p < 0.001). Neither age at operation nor gender influenced the score results significantly, while the aetiology of talonavicular degeneration showed a significant effect. Mean visual analogue scale (VAS) pain intensity (0-10) reduced from 8.6 to 1.7 (p < 0.001). Good or excellent results were achieved in 26 patients, while two patients reported fair and another two poor results. Complete osseous fusion was observed at a mean of 10.9 weeks (8-13) postoperatively.
For the treatment of talonavicular arthritis, the application of mono- and multidirectional angle-stable mini-plates provided a strong fixation that led to high union rates and good to excellent overall outcome.
距跟关节是人类足部的中心连接。症状性距跟关节炎可以通过孤立的距跟关节融合得到充分解决。然而，对于骨科医生来说，不愈合仍然是一个相关的临床挑战。本研究的目的是分析使用角度稳定型微型钢板进行距跟关节融合的临床和影像学结果。
我们在 2005 年至 2007 年间对 30 名患者（12 名男性，18 名女性）进行了 30 例距跟关节融合术，平均年龄为 58.8 岁（范围为 22-74 岁）。使用单方向和多方向角度稳定微型钢板实现骨关节融合。患者遵循标准化的固定和负重方案。平均术后随访时间为 15.8 个月（6.1-23.8）。
美国矫形足踝协会 AOFAS 评分从 31.7（19-42）显著增加到 82.3 分（55-97）（p<0.001）。手术时的年龄和性别对评分结果没有显著影响，而距跟关节退变的病因则有显著影响。平均视觉模拟量表（VAS）疼痛强度（0-10）从 8.6 降至 1.7（p<0.001）。26 名患者获得良好或优秀结果，2 名患者报告一般，另外 2 名患者报告较差。术后平均 10.9 周（8-13 周）观察到完全骨性融合。
对于距跟关节炎的治疗，应用单方向和多方向角度稳定型微型钢板提供了强大的固定，导致高融合率和良好至优秀的总体结果。
