Cao Hong-Hui, Lu Wei-Zhong, Tang Kang-Lai
Department of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical University, Gaotanyan Str. 30, Chongqing, 400038, People's Republic of China.
Department of Orthopaedic Surgery, The Traditional Medical Hospital of Chongqing, China, The Brach 4th Panxi Road, Jiangbei, Chongqing, 400021, People's Republic of China.
J Orthop Surg Res. 2017 Jun 5;12(1):83. doi: 10.1186/s13018-017-0581-4.
The study aimed to introduce the isolated talonavicular and talonavicular-cuneiform arthrodesis for the stage III and IV Müller-Weiss disease and analyze their clinical outcomes.
Thirty patients of stage III and IV Müller-Weiss disease were divided into the talonavicular (TN) arthrodesis group and the talonavicular-cuneiform (TNC) arthrodesis group according to the perinavicular osteoarthritis by MRI scans. For the isolated talonavicular arthrodesis group, 16 patients underwent talonavicular arthrodesis with two 4.0 mm hollow headless compression screws. For the TNC arthrodesis group, 14 patients were received the TNC arthrodesis with reverse "V" shape osteotomy and autoallergic iliac bone graft. All patients were followed up at 3, 6, 9, and 12 months, and per 6 months after 1 year, by the AOFAS ankle-midfoot scores, and evaluated by radiographic measurements.
All of them were followed up in two groups and all patients were satisfied with their clinical results. At the TN arthrodesis group, the patients' mean was 39.8 months (range, 11-66 months) follow-up. The mean AOFAS ankle and hindfoot scores had improved from 38.3 ± 5.1 preoperatively to 88.9 ± 1.9 at the last postoperative assessment. At the TNC arthrodesis group, the mean follow-up was 51.7 months (range, 12-90 months). The mean AOFAS ankle and hindfoot scores were 40.1 ± 7.9 preoperatively to 90.1 ± 2.0 at the last postoperative. All of the cases were solid fusion on the radiograph.
According to MRI evaluation, either TN or TNC arthrodesis for stage III or IV Müller-Weiss disease have the good clinical outcomes with solid fusion rate and obvious improvement of the quality of life of patients.
本研究旨在介绍用于治疗 Müller-Weiss 病 III 期和 IV 期的单纯距舟关节融合术和距舟-楔骨关节融合术，并分析其临床疗效。
根据 MRI 扫描显示的舟周骨关节炎情况，将 30 例 Müller-Weiss 病 III 期和 IV 期患者分为距舟（TN）关节融合术组和距舟-楔骨（TNC）关节融合术组。在单纯距舟关节融合术组中，16 例患者采用两枚 4.0 毫米空心无头加压螺钉进行距舟关节融合术。在 TNC 关节融合术组中，14 例患者接受了反向“V”形截骨术和自体髂骨移植的 TNC 关节融合术。所有患者在术后 3、6、9 和 12 个月进行随访，术后 1 年每 6 个月随访一次，采用美国足踝外科协会（AOFAS）踝-中足评分，并通过影像学测量进行评估。
两组患者均获得随访，所有患者对临床结果均满意。在 TN 关节融合术组，患者平均随访 39.8 个月（范围 11 - 66 个月）。末次术后评估时，平均 AOFAS 踝与后足评分从术前的 38.3 ± 5.1 提高到 88.9 ± 1.9。在 TNC 关节融合术组，平均随访 51.7 个月（范围 12 - 90 个月）。末次术后时，平均 AOFAS 踝与后足评分从术前的 40.1 ± 7.9 提高到 90.1 ± 2.0。所有病例在 X 线片上均达到牢固融合。
根据 MRI 评估，对于 Müller-Weiss 病 III 期或 IV 期患者，TN 或 TNC 关节融合术均具有良好的临床疗效，融合率高，患者生活质量明显改善。
