Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
J Orthop Surg Res. 2023 Mar 14;18(1):202. doi: 10.1186/s13018-023-03691-y.
Paralytic foot-drop is a disabling deformity that results from nerve or direct muscle injuries. Palliative surgeries such as tendon transfer and ankle arthrodesis are reserved for permanent deformity, with the arthroscopic technique had not been widely studied before. This study aims to evaluate the clinical outcome and quality of life after arthroscopic ankle fusion of paralytic foot-drop deformity.
The patients who were retrospectively enrolled in this study underwent arthroscopic ankle fusion for paralytic foot-drop deformity between March 2017 and December 2021. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Cumberland Ankle Instability Tool (CAIT) were the measures used for clinical assessment. To judge the union, serial plain radiographs of the ankle were obtained. The preoperative and postoperative means were analyzed utilizing a two-tailed paired t-test, with a p value of less than 0.05 indicating statistical significance.
This study included 21 consecutive patients with a mean follow-up of 35.09 ± 4.5 months and a mean age of 41.5 ± 6.1 years. Highly significant improvements were observed between the preoperative and final follow-up means of the AOFAS score (from 57.6 ± 4.6 to 88.3 ± 2.7) and CAIT (from 12.1 ± 2.2 to 28.9 ± 1.01; p ˂ 0.00001 for both). All patients attained radiographic union and resumed their previous occupations without reporting serious adverse effects.
Arthroscopic ankle fusion is an effective, minimally invasive palliative surgery for patients suffering from permanent paralytic foot-drop deformity. This technique was shown to provide good functional and radiologic outcomes without significant complications.
Retrospective cohort; level of evidence (IV).
弛缓性足下垂是一种由神经或直接肌肉损伤引起的致残性畸形。肌腱转移和踝关节融合术等姑息性手术仅用于永久性畸形，关节镜技术在此之前并未得到广泛研究。本研究旨在评估关节镜下治疗弛缓性足下垂畸形的踝关节融合术的临床效果和生活质量。
本研究回顾性纳入了 2017 年 3 月至 2021 年 12 月间接受关节镜下治疗的 21 例弛缓性足下垂畸形患者。采用美国矫形足踝协会（AOFAS）踝-后足评分和坎伯兰踝关节不稳定工具（CAIT）进行临床评估。通过连续拍摄踝关节的 X 线片来判断是否愈合。采用双侧配对 t 检验对术前和术后的平均值进行分析，p 值小于 0.05 表示有统计学意义。
本研究共纳入 21 例连续患者，平均随访 35.09±4.5 个月，平均年龄为 41.5±6.1 岁。AOFAS 评分（从术前的 57.6±4.6 分提高到最终随访时的 88.3±2.7 分）和 CAIT（从术前的 12.1±2.2 分提高到最终随访时的 28.9±1.01 分；均 p＜0.00001）均有显著改善。所有患者均获得影像学愈合，恢复了以前的职业，无严重不良事件报告。
关节镜下踝关节融合术是治疗永久性弛缓性足下垂畸形的一种有效、微创的姑息性手术。该技术具有良好的功能和影像学效果，且无明显并发症。
回顾性队列研究；证据等级（IV）。
