Chen Pu, Guan Hua, Feng Enhui, Liang Jiachang, Xu Yiyin, He Jianbo, Huang Weiming, Xie Jiewei
Department of Foot and Ankle Trauma, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou Guangdong, 510120, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Aug 15;39(8):1008-1013. doi: 10.7507/1002-1892.202503098.
To evaluate the short-term effectiveness of Ilizarov technique combined with steel needle internal fixation in treating Charcot neuroarthropathy (CN) of the foot and ankle.
Between June 2020 and December 2023, 12 patients with Eichenholtz stage Ⅲ CN of the foot and ankle were treated with Ilizarov technique and steel needle internal fixation. There were 9 males and 3 females with an average age of 48.6 years (range, 19-66 years). The disease duration ranged from 1 to 16 months (mean, 6.8 months). Ankle joint involvement predominated in 7 cases, while midfoot involvement occurred in 5 cases; 3 cases presented with skin ulceration and soft tissue infection. Preoperative American Orthopedic Foot and Ankle Society (AOFAS) score was 31.2±9.0, 36-Item Short-Form Health Survey (SF-36)-Physical Component Summary (PCS) score was 32.6±6.8, and Mental Component Summary (MCS) score was 47.8±8.4. Postoperative assessments included wound healing, regular X-ray film/CT evaluations of fusion status, and effectiveness via AOFAS and SF-36-PCS, MCS scores.
All operations were successfully completed without neurovascular complication. Two patients experienced delayed wound healing requiring intervention, and the others achieved primary healing. All patients were followed up 15-43 months (mean, 23.3 months). Imaging confirmed successful joint fusion within 13-21 weeks (mean, 16.8 weeks). At last follow-up, the AOFAS score was 72.5±6.4, and the SF-36-PCS and MCS scores were 63.2±8.4 and 76.7±5.3, respectively, all of which improved compared to preoperative levels, with significant differences ( <0.05).
Ilizarov technique combined with steel needle internal fixation effectively restores walking function and achieves satisfactory short-term effectiveness in CN of the foot and ankle.
评估伊里扎洛夫技术联合钢针内固定治疗足踝部夏科氏神经关节病（CN）的短期疗效。
2020年6月至2023年12月，对12例足踝部艾兴霍尔茨Ⅲ期CN患者采用伊里扎洛夫技术和钢针内固定治疗。其中男性9例，女性3例，平均年龄48.6岁（范围19 - 66岁）。病程1至16个月（平均6.8个月）。踝关节受累7例，中足受累5例；3例出现皮肤溃疡和软组织感染。术前美国矫形足踝协会（AOFAS）评分为31.2±9.0，36项简明健康调查问卷（SF - 36）-身体成分总结（PCS）评分为32.6±6.8，心理成分总结（MCS）评分为47.8±8.4。术后评估包括伤口愈合情况、定期X线片/CT评估融合状态，以及通过AOFAS和SF - 36 - PCS、MCS评分评估疗效。
所有手术均成功完成，无神经血管并发症。2例患者伤口愈合延迟需干预，其余患者伤口一期愈合。所有患者随访15 - 43个月（平均23.3个月）。影像学证实13 - 21周（平均16.8周）内关节融合成功。末次随访时，AOFAS评分为72.5±6.4，SF - 36 - PCS和MCS评分分别为63.2±8.4和76.7±5.3，均较术前改善，差异有统计学意义（<0.05）。
伊里扎洛夫技术联合钢针内固定可有效恢复足踝部CN患者的行走功能，取得满意的短期疗效。
