Kitaoka H B, Patzer G L
Department of Orthopedics, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
J Bone Joint Surg Am. 1998 Mar;80(3):370-9.
We evaluated the results of arthrodesis that had been performed for arthrosis of the ankle and osteonecrosis of the talus in nineteen patients. Twelve patients were men, and seven were women. The mean age of the patients was thirty-four years (range, nineteen to fifty-eight years). The median interval between the injury and the index operation was twenty-one months (range, six to 408 months). The arthrodesis was performed at the level of the ankle only in three patients and in both the ankle and the subtalar joint in sixteen. External fixation was used in thirteen patients, internal fixation was used in four, and no fixation was used in two. Supplemental bone graft from the iliac crest was used in fourteen patients, and local bone graft was used in five. The mean duration of follow-up was six years (range, two to fifteen years). The clinical result was excellent in seven patients, good in six, fair in three, and poor in three. Union was achieved in sixteen ankles, but it was delayed in one of them. Complications occurred in four patients: one had a tibial stress fracture, one had an infection at the site of a non-union, and two had malalignment in plantar flexion. Overall, the arthrodesis was successful in these patients. The use of rigid fixation and bone-grafting had a rate of success approximating that reported for primary arthrodesis in patients who do not have avascular necrosis.
我们评估了为19例踝关节骨关节炎和距骨骨坏死患者施行关节融合术的结果。其中12例为男性，7例为女性。患者的平均年龄为34岁（范围为19至58岁）。受伤至初次手术的中位间隔时间为21个月（范围为6至408个月）。仅在3例患者中于踝关节水平施行关节融合术，16例患者在踝关节和距下关节均施行关节融合术。13例患者采用了外固定，4例采用了内固定，2例未采用固定。14例患者使用了取自髂嵴的补充性骨移植，5例使用了局部骨移植。平均随访时间为6年（范围为2至15年）。临床结果为7例患者优，6例患者良，3例患者可，3例患者差。16个踝关节实现了融合，但其中1个出现了延迟融合。4例患者发生了并发症：1例发生胫骨应力性骨折，1例在不愈合部位发生感染，2例出现跖屈畸形。总体而言，这些患者的关节融合术是成功的。使用坚强内固定和骨移植的成功率与报道的无血管坏死患者初次关节融合术的成功率相近。
