Department of Traumatology, Orthopedics and Surgery of Extreme Conditions, Kazan State Medical University, 49 Butlerova, Tatarstan Respublika, Kazan 420012, Russian Federation; Trauma Department, The Central Hospital of WuHan (Affiliated to Tongji Medical College, Huazhong University of Science and Technology), 26 Shengli Street, Wuhan 430014, China.
Trauma Department, The Central Hospital of WuHan (Affiliated to Tongji Medical College, Huazhong University of Science and Technology), 26 Shengli Street, Wuhan 430014, China.
Injury. 2023 Jul;54(7):110794. doi: 10.1016/j.injury.2023.05.025. Epub 2023 May 6.
This study aimed to compare the efficacy of arthrodesis with various fixation methods in the treatment of advanced ankle osteoarthritis. Thirty-two patients with osteoarthritis of the ankle (mean age 59.91±6.16 years) took part in the study. The patients were divided into 2 groups - Ilizarov apparatus (21 patients) and screw fixation (11 patients). Each group was also divided into subgroups based on etiology - posttraumatic and nontraumatic. The AOFAS and VAS scales were compared in the preoperative and postoperative periods. It was found that screw fixation was more effective in the treatment of late stages of osteoarthritis (OA) of the ankle during the postoperative period. Comparison of the AOFAS and VAS scales showed no significant differences between the groups in the preoperative period (p = 0.838; p = 0.937). After 6 months, the results were better in the screw fixation group (p = 0.042; p = 0.047). Complications were observed for a third of the patients (10 patients). 6 patients had pain in the operated limb (4 patients in the Ilizarov apparatus group). Three patients in the Ilizarov apparatus group developed a superficial infection, and one developed a deep infection. Different etiology did not affect the postoperative efficacy of arthrodesis. The choice of the type of should be related to a clear protocol for the presence of complications. When choosing the type of fixation for arthrodesis, a patient's condition as well as a surgeon's preferences should be taken into account.
本研究旨在比较不同固定方法在治疗晚期踝关节骨关节炎中的疗效。32 名踝关节骨关节炎患者(平均年龄 59.91±6.16 岁)参与了这项研究。患者被分为 2 组 - Ilizarov 器械组(21 例)和螺钉固定组(11 例)。每组还根据病因进一步分为创伤后和非创伤后亚组。比较术前和术后 AOFAS 和 VAS 评分。结果发现,螺钉固定在治疗晚期踝关节骨关节炎(OA)方面更有效。比较 AOFAS 和 VAS 评分,两组患者在术前均无显著差异(p=0.838;p=0.937)。6 个月后,螺钉固定组的结果更好(p=0.042;p=0.047)。三分之一的患者出现并发症(10 例)。6 例患者出现患肢疼痛(Ilizarov 器械组 4 例)。3 例 Ilizarov 器械组患者发生浅表感染,1 例发生深部感染。不同病因并不影响融合术后的疗效。固定类型的选择应与存在并发症的明确方案相关。当选择融合术的固定类型时,应考虑患者的病情和外科医生的偏好。