Cracchiolo A, Pearson S, Kitaoka H, Grace D
Division of Orthopaedic Surgery, University of California, School of Medicine, Los Angeles 90024-6902.
Clin Orthop Relat Res. 1990 Aug(257):193-203.
Surgical fusion may be indicated to stabilize deformed or painful hindfoot joints. Although more commonly performed in children or adolescents, it is the salvage procedure available for adults. Twenty-six patients (30 feet; 20 women, six men) followed for an average of 44.1 months after hindfoot arthrodesis were investigated in a prospective study. Most (20 patients, 24 feet) had inflammatory arthritis, usually rheumatoid, two had previous fractures, and four patients had other diagnoses. All had fusions done using a dowel graft technique. Twenty-four patients (92%) were completely satisfied with the operation, one had mild reservations, and the one dissatisfied patient was a technical failure. All joints were fused utilizing clinical and roentgenographic evaluation. A detailed roentgenographic assessment indicated that the talometatarsal angle was the most effective measurement to assess the clinical deformity. Anteroposterior weight-bearing roentgenograms of the ankle were also important in evaluating these patients preoperatively and postoperatively. Postoperatively, only nine ankles appeared normal roentgenographically, while the others worsened, and four required ankle arthrodesis.
手术融合可用于稳定畸形或疼痛的后足关节。虽然该手术在儿童或青少年中更为常见，但它也是适用于成人的挽救性手术。在一项前瞻性研究中，对26例患者（30足；20名女性，6名男性）进行了调查，这些患者在后足关节融合术后平均随访了44.1个月。大多数患者（20例患者，24足）患有炎性关节炎，通常为类风湿性关节炎，2例曾有骨折，4例患者有其他诊断。所有患者均采用榫钉移植技术进行融合。24例患者（92%）对手术完全满意，1例有轻微保留意见，1例不满意患者手术技术失败。所有关节均通过临床和X线评估实现融合。详细的X线评估表明，距跖角是评估临床畸形最有效的测量指标。踝关节前后位负重X线片在术前和术后评估这些患者时也很重要。术后，只有9个踝关节X线表现正常，而其他踝关节情况恶化，4个踝关节需要进行踝关节融合术。
