Wang Xuewen, Li Heng, Gong Xiaofeng, Lai Liangpeng, Li Wenjing, Wang Yan, Du Hui, Li Ying, Sun Ning, Wu Yong
Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Jul 15;37(7):776-781. doi: 10.7507/1002-1892.202303099.
To evaluate the early effectiveness of a new minimally invasive plate in the treatment of varus-type ankle arthritis.
A clinical data of 15 patients with varus-type ankle arthritis who met the selection criteria between March 2021 and October 2021 were retrospectively analyzed. All the patients were treated with medial open-wedge supramalleolar osteotomy and fibular osteotomy. The osteotomies were fixed with the new minimally invasive plate. There were 7 males and 8 females with an average age of 49.8 years (range, 16-71 years). The causes of ankle arthritis included post-fracture deformity in 1 case, sprain in 8 cases, and acquired clubfoot in 1 case; and 5 cases were without obvious factors. The disease duration ranged from 1 to 12 years, with an average of 4.1 years. Comparisons were made between pre-operation and the last follow-up in the Takakura staging, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, foot function index (FFI), visual analogue scale (VAS) score, tibial anterior surface angle (TAS), tibial lateral surface angle (TLS), and talar tilt (TT).
All incisions healed by first intention. All patients were followed up 7-18 months (mean, 12.8 months). At last follow-up, the AOFAS ankle-hindfoot score, FFI, VAS score, and Takakura staging significantly improved when compared with the preoperative ones ( <0.05). X-ray films showed that the osteotomy healed at 3 months after operation. At last follow-up, TAS significantly increased and TT decreased when compared with the preoperative ones ( <0.05), and the difference in TLS between pre- and post-operation was not significant ( >0.05). Complications included 1 case of intraoperative screw breakage and 2 cases of nerve injury of the affected foot. None of the patients complained of significant discomfort at the plate placement during follow-up, and no loosening of the internal fixator occurred. Eleven patients were very satisfied with the effeectiveness, while 4 were relatively satisfied.
The new minimally invasive plate for the varus-type ankle arthritis has good early effectiveness in relieving ankle pain, correcting deformity, improving limb alignment and ankle function, and reducing the incidence of postoperative incisional complications.
评估一种新型微创钢板治疗内翻型踝关节关节炎的早期疗效。
回顾性分析2021年3月至2021年10月间15例符合入选标准的内翻型踝关节关节炎患者的临床资料。所有患者均接受内侧开放性楔形距上截骨术和腓骨截骨术。截骨处采用新型微创钢板固定。其中男性7例，女性8例，平均年龄49.8岁（范围16 - 71岁）。踝关节关节炎的病因包括骨折后畸形1例、扭伤8例、后天性马蹄内翻足1例；5例无明显病因。病程1至12年，平均4.1年。比较术前与末次随访时的高仓分期、美国矫形足踝协会（AOFAS）踝后足评分、足部功能指数（FFI）、视觉模拟量表（VAS）评分、胫骨前表面角（TAS）、胫骨外侧表面角（TLS）和距骨倾斜（TT）。
所有切口均一期愈合。所有患者均获随访7 - 18个月（平均12.8个月）。末次随访时，与术前相比，AOFAS踝后足评分、FFI、VAS评分和高仓分期均显著改善（<0.05）。X线片显示截骨术后3个月愈合。末次随访时，与术前相比，TAS显著增加，TT降低（<0.05），术前与术后TLS差异无统计学意义（>0.05）。并发症包括术中螺钉断裂1例，患足神经损伤2例。随访期间无患者主诉钢板置入处明显不适，未发生内固定松动。11例患者对疗效非常满意，4例相对满意。
新型微创钢板治疗内翻型踝关节关节炎在缓解踝关节疼痛、矫正畸形、改善肢体对线和踝关节功能以及降低术后切口并发症发生率方面具有良好的早期疗效。
