Zhang Lei, Wang Xinwei, Chen Yusheng, Wan Mingcai, Chen Jiangfei
The 1st Department of Osteomyelitis, Henan Luoyang Orthopedic-Traumatological Hospital, Henan Orthopedic Hospital, Luoyang Henan, 471002, P.R.China.
The 1st Department of Osteomyelitis, Henan Luoyang Orthopedic-Traumatological Hospital, Henan Orthopedic Hospital, Luoyang Henan, 471002,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Sep 15;31(9):1059-1063. doi: 10.7507/1002-1892.201610019.
To evaluate the effectiveness of Ilizarov technique and tibiotalar or tibiocalcanean arthrodesis for one-stage treatment of ankle joints infection and bone defects.
Between January 2014 and April 2016, 14 patients with ankle joints infection and bone defects were treated by Ilizarov technique and tibiotalar or tibiocalcanean arthrodesis for one-stage. There were 12 males and 2 females with an average age of 39.8 years (range, 25-61 years). The causes of ankle infection included falling from height injury in 5 cases, falling injury in 4 cases, traffic accident injury in 1 case, crushing injury in 1 case, sprain injury in 1 case, and hematogenous reason in 2 cases. All the patients received surgery for 0-8 times (mean, 3.7 times) before admission. The modified American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score was 30.25±3.54 before operation. The disease duration was 1-30 months (mean, 10.3 months).
All the incisions healed by first intension without recurrence of infection, and two-stage bone grafting operation did not performed. One case felt slight local pain and swell of ankle joint after weight-bearing walking more than 30 minutes, and without special treatment. All the patients had different degree skin redness and swelling of Kirschner wire pinhole for 0-3 times, and relieved after symptomatic treatment. All the patients were followed up 6-27 months (mean, 16.8 months). Except for 2 cases who did not remove the external fixator (with external fixation time of 6 months and 8 months respectively), the other patients removed the external fixator at 6-14 months (mean, 9 months) after operation, all patients recovered the walk function and without ankle pain. The modified AOFAS ankle and hindfoot score after removal of external fixator (70.92±1.0) was significantly higher than preoperative one ( =-10.992, =0.000).
It is a simple and effective method for one-stage treatment of ankle joints infection and bone defects by Ilizarov technique and tibiotalar or tibiocalcanean arthrodesis.
评估伊里扎洛夫技术及胫距或胫跟关节融合术一期治疗踝关节感染并骨缺损的有效性。
2014年1月至2016年4月，对14例踝关节感染并骨缺损患者采用伊里扎洛夫技术及胫距或胫跟关节融合术进行一期治疗。其中男12例，女2例，平均年龄39.8岁（范围25 - 61岁）。踝关节感染原因包括高处坠落伤5例、跌倒伤4例、交通事故伤1例、挤压伤1例、扭伤1例、血源性原因2例。所有患者入院前接受手术0 - 8次（平均3.7次）。术前改良美国矫形足踝协会（AOFAS）踝与后足评分为30.25±3.54分。病程1 - 30个月（平均10.3个月）。
所有切口均一期愈合，无感染复发，未行二期植骨手术。1例患者负重行走30分钟以上后踝关节局部有轻微疼痛及肿胀，未作特殊处理。所有患者克氏针针孔处皮肤出现不同程度红肿0 - 3次，经对症处理后缓解。所有患者随访6 - 27个月（平均16.8个月）。除2例未拆除外固定器（外固定时间分别为6个月和8个月）外，其他患者术后6 - 14个月（平均9个月）拆除外固定器，所有患者均恢复行走功能，无踝关节疼痛。拆除外固定器后改良AOFAS踝与后足评分（70.92±1.0）显著高于术前（ = - 10.992， = 0.000）。
伊里扎洛夫技术及胫距或胫跟关节融合术一期治疗踝关节感染并骨缺损是一种简单有效的方法。
