Sangeorzan B J, Smith D, Veith R, Hansen S T
Department of Orthopaedics, University of Washington Harborview Medical Center, Seattle.
Clin Orthop Relat Res. 1993 Sep(294):299-307.
Forty adult patients with 44 fused feet were evaluated at an average of 4.9 years after triple arthrodesis. The average age of the patients at operation was 41 years. All operations were performed by a specific technique using rigid internal fixation with screws. Outcome was graded using the clinical criteria of Hallgrimsson as modified by Angus and Cowell. Function was evaluated according to modified Arthritis Impact Measurement Scales (AIMS). Radiographic evaluation included measurement of lateral talocalcaneal angle, lateral talometatarsal angle, and anteroposterior (AP) talometatarsal angle on standing or simulated weight-bearing radiographs. Thirty-four feet had good results, six had fair results, and there were four failures. The average patient could function painlessly on flat surfaces in nonstrenuous activities and had only occasional mild pain with more vigorous activities. In roentgenographic parameters, there was an average improvement of 17 degrees in the lateral talometatarsal angle, 11 degrees improvement in the lateral talocalcaneal angle, and an improvement of 18 degrees in the AP talometatarsal angle. There were two pseudarthroses, no recurrences, and two unsatisfactory corrections. When carefully done, triple arthrodesis can restore an adult patient with a disabling foot disorder to normal function and minimal pain.
44 例足部融合的成年患者在三关节融合术后平均 4.9 年接受了评估。患者手术时的平均年龄为41岁。所有手术均采用特定技术，使用螺钉进行坚强内固定。根据 Angus 和 Cowell 修改后的 Hallgrimsson 临床标准对结果进行分级。根据修改后的关节炎影响测量量表（AIMS）评估功能。影像学评估包括在站立位或模拟负重 X 光片上测量外侧距跟角、外侧距舟角和前后位（AP）距舟角。34 只脚结果良好，6 只脚结果尚可，4 只脚手术失败。平均而言，患者在非剧烈活动的平坦地面上可无痛活动，只有在剧烈活动时偶尔会感到轻微疼痛。在影像学参数方面，外侧距舟角平均改善 17 度，外侧距跟角改善 11 度，前后位距舟角改善 18 度。有 2 例假关节形成，无复发，2 例矫正效果不满意。如果操作仔细，三关节融合术可使患有致残性足部疾病的成年患者恢复正常功能并将疼痛降至最低。
