Graves S C, Mann R A, Graves K O
Campbell Clinic, Memphis, Tennessee 38120.
J Bone Joint Surg Am. 1993 Mar;75(3):355-62. doi: 10.2106/00004623-199303000-00006.
We studied the results for seventeen patients (eighteen feet) who had had a triple arthrodesis at an average age of sixty-six years (range, fifty-two to eighty years). There were twelve women and five men. The procedures had been performed to correct deformities of the hindfoot and midfoot caused by an untreated rupture of the posterior tibial tendon in ten patients; by rheumatoid arthritis in three patients (four feet); and by neuropathic arthropathy (associated with diabetes mellitus), trauma, old poliomyelitis, and a stroke in one patient each. The average duration of follow-up was forty-two months (range, twenty-seven to 156 months). At the most recent follow-up examination, three patients had a non-union (one, of the talonavicular joint and two, of the calcaneocuboid joint), six patients (seven feet) had progressive degenerative joint disease involving the ankle, seven had progressive degenerative changes in the mobile joints of the feet, two had had an infection but both infections had healed, and one had had postoperative collapse of the foot because of premature, unauthorized weight-bearing. In one patient, a staple across the subtalar joint had been removed because of pain caused by impingement of the staple on the tip of the fibula. Over-all, fourteen of the seventeen patients were satisfied with the result of the operation. All seventeen had less pain postoperatively, but eleven still had some discomfort.(ABSTRACT TRUNCATED AT 250 WORDS)
我们研究了17例患者（18只足）的治疗结果，这些患者平均66岁（年龄范围52至80岁）时接受了三关节融合术。其中女性12例，男性5例。手术目的为矫正畸形，10例患者因胫后肌腱未治疗的断裂导致后足和中足畸形；3例患者（4只足）因类风湿性关节炎；另外4例患者分别因神经性关节病（与糖尿病相关）、创伤、陈旧性脊髓灰质炎和中风导致的畸形。平均随访时间为42个月（范围27至156个月）。在最近一次随访检查时，3例患者出现不愈合（距舟关节1例，跟骰关节2例），6例患者（7只足）出现累及踝关节的进行性退行性关节病，7例患者足部活动关节出现进行性退变，2例患者曾发生感染但均已愈合，1例患者因过早、未经许可负重导致术后足部塌陷。1例患者因钢板撞击腓骨尖引起疼痛，已取出距下关节的钢板。总体而言，17例患者中有14例对手术结果满意。所有17例患者术后疼痛均减轻，但1例仍有一些不适。（摘要截取自250字）
