Mazur J M, Schwartz E, Simon S R
J Bone Joint Surg Am. 1979 Oct;61(7):964-75.
A functional assessment of twelve patients after ankle arthrodesis for post-traumatic arthritis was carried out by means of an extensive clinical evaluation and gait analysis after an average follow-up of eight years. A weighted point system was developed to grade ankle function clinically. The data on gait analysis were examined to determine the effect of arthrodesis of the ankle on the over-all pattern of walking. Under conditions of normal daily living while wearing shoes, all patients functioned well after arthrodesis. The gait-analysis data obtained with the patients wearing shoes showed excellent gait characteristics, and the ankle motion that had been lost was compensated for by: (1) motion of the small joints of the ipsilateral foot; (2) altered motion of the ankle in the contralateral limb; and (3) appropriate footwear. While the patients were walking barefooted, some adverse effects of fusion of the ankle were evident. Velocity of gait was slowed and the length of stride was shortened in all twelve patients. One patient whose ankle had been fused in an equinus position had a back-knee deformity during stance phase, and another walked only on his toes when he was without shoes. The gait patterns of all patients were markedly improved when they were wearing shoes with appropriate heel heights.
对12例因创伤后关节炎接受踝关节融合术的患者进行了功能评估，评估方法为在平均随访8年后进行全面的临床评估和步态分析。开发了一个加权评分系统以对踝关节功能进行临床分级。对步态分析数据进行检查，以确定踝关节融合术对整体步行模式的影响。在正常日常生活且穿鞋的情况下，所有患者在融合术后功能良好。患者穿鞋时获得的步态分析数据显示出良好的步态特征，已丧失的踝关节活动通过以下方式得到代偿：（1）同侧足部小关节的活动；（2）对侧肢体踝关节活动的改变；（3）合适的鞋具。当患者赤足行走时，踝关节融合的一些不良影响较为明显。所有12例患者的步态速度减慢，步幅缩短。1例踝关节融合于马蹄足位的患者在站立期出现后膝畸形，另1例患者不穿鞋时只能用脚尖行走。当患者穿着具有合适鞋跟高度的鞋子时，所有患者的步态模式均有明显改善。
