Department and Clinic of Orthopaedic and Traumatologic Surgery, Wrocław Medical University, ul. Borowska 213, 50-556, Wrocław, Poland.
Faculty of Health Sciences and Physical Education, Witelon State University of Applied Sciences, Legnica, Poland.
Biomed Eng Online. 2018 Nov 26;17(1):174. doi: 10.1186/s12938-018-0608-z.
A number of various techniques were proposed to stabilized ankle arthrodesis, among them external and internal fixation. Appropriate balance and adequate distribution of lower limb loads determine normal biomechanics of the locomotor system. We hypothesized that various techniques used to stabilize ankle arthrodesis may exert different effects on (1) balance and (2) distribution of lower limb loads.
Retrospective analysis included 47 patients who underwent ankle arthrodesis with external stabilization with Ilizarov fixator (group 1, n = 21) or internal stabilization with screws (group 2, n = 26) between 2007 and 2015. Balance and distribution of lower limb loads were determined with a pedobarographic platform.
In group 1, average load of the operated and non-operated limb amounted to 48.8% and 51.2%, respectively, and in group subjected to internal stabilization to 48.4% and 51.6%, respectively. Neither the intragroup nor the intergroup differences in the distribution of lower limb loads were statistically significant. Mean length of the center of gravity (COG) path was 137.9 cm for group 1 and 134 cm for group 2, and mean COG area amounted to 7.41 cm and 6.16 cm, respectively. The latter intergroup difference was statistically significant.
Balance after ankle arthrodesis with Ilizarov fixation is worse than after the same procedure with internal stabilization. Despite correction of ankle deformity, musculoskeletal biomechanics still remains impaired. While ankle fusion with either Ilizarov or internal fixation provide appropriate distribution of lower limb loads, none of these procedures normalize patients' balance.
为了稳定踝关节融合术，提出了许多不同的技术，包括外部固定和内部固定。适当的平衡和下肢负荷的充分分布决定了运动系统的正常生物力学。我们假设，用于稳定踝关节融合术的各种技术可能对（1）平衡和（2）下肢负荷的分布产生不同的影响。
回顾性分析了 2007 年至 2015 年间接受外固定架（伊里扎洛夫固定器）（1 组，n=21）或内固定（螺钉）（2 组，n=26）治疗的 47 例踝关节融合术患者。使用足底压力平台确定平衡和下肢负荷分布。
在 1 组中，患侧和健侧的平均负荷分别为 48.8%和 51.2%，而在接受内固定的 2 组中，患侧和健侧的平均负荷分别为 48.4%和 51.6%。无论是组内还是组间，下肢负荷分布的差异均无统计学意义。1 组的重心（COG）轨迹平均长度为 137.9cm，2 组为 134cm，COG 面积分别为 7.41cm 和 6.16cm，两组间差异有统计学意义。
伊里扎洛夫固定踝关节融合术后的平衡比内固定相同手术差。尽管矫正了踝关节畸形，但肌肉骨骼生物力学仍然受损。虽然伊里扎洛夫或内固定的踝关节融合术提供了适当的下肢负荷分布，但这些方法都不能使患者的平衡正常化。
