摘要
目的探讨Muller—Weiss病的手术治疗和疗效。方法2005年3月至2011年5月，对15例（15足）Muller—Weiss病的患者进行手术治疗，男性2例，女性13例；年龄26～62岁，平均51．8岁。术前美国足踝医师协会（AOFAS）踝-后足评分为（42±13）分。根据Maceira分期，2期1例，3期6例，4期4例，5期4例。根据术前评估，采用的手术方法有应用接骨板行距舟楔关节融合术、应用接骨板行距舟关节融合和舟楔关节固定术、应用螺钉行三关节融合术。结果应用接骨板行距舟楔关节融合术10例，应用接骨板行距舟关节融合和舟楔关节固定术3例，应用螺钉行三关节融合术2例。13例患者获得9～38个月随访，平均19．2个月。所有患足都获得融合，融合时间为12～16周，平均13．3周。末次随访AOFAS踝．后足评分为（83±6）分，优2例、良10例、可1例。足长度术前为（14．2±1．0）cm，末次随访时为（15．7±0．9）cm（t=11．570，P〈0．05）；Meaty角术前为-6．1°±13．1°，末次随访时为1．1°±3．0°（t=2．248，P〈0．05）；距跟角术前为4．5°±2．2°，末次随访时为18．0°±4．0°（t=11．700，P〈0．05）。所有患者术后均未发生切口感染，舟楔关节固定处接骨板和螺钉断裂1例。结论对Muller—Weiss病进行手术治疗，根据具体情况采用不同的治疗方案，可以取得满意疗效．
Objective To discuss operative methods and effects for MUller-Weiss disease. Methods From March 2005 to May 2011,15 patients were operated. There were 2 males and 13 females,with an average age of 51.8 years （range, 26 to 62 years）. The preoperative American Orthopaedic Foot and Ankle Society（AOFAS） ankle-hindfoot score was （42 ± 13）points, According to the Maceira Staging system, 1 foot was grade 2, 6 feet were grade 3, 4 feet were grade 4, and 4 feet were grade 5. The technique consisted of arthrodesis of the talouaviculocuueiform joints with plate, arthrodesis of the talonavicular joint and arthrorisis of naviculocuneiform joint with plate, or triple arthrodesis with screws, according to the preoperative evaluation. Results Ten feet were treated with arthrodesis of the talonaviculocuneiform joints, 3 feet were treated with arthrodesis of the talonavicular joint and arthrorisis of naviculocuneiform joint and 2 feet were treated with triple arthrodesis. Two patients were lost to follow-up. The average follow-up after operation was 19. 2 months （range, 9 to 38 months）. All feet were solid fusion and the average duration of union was 13.3 weeks （range, 12-16 weeks）. The AOFAS ankle-hindfoot score at the last follow-up was （83 ± 6） points. Two feet were excellent, 10 feet were good, and 1 foot was fair. The length of feet was （ 14. 2 ± 1.0） cm before surgery and （ 15.7 ± 0. 9 ） cm at the last follow-up （ t = 11. 570, P 〈 0.05 ）. The Meary＇s angle was - 6. 1 ° ± 13.1 ° before surgery and 1.1 ° ± 3.0° at the last follow-up （ t = 2. 248, P 〈 0. 05）. The taloealcaneal angle was 4. 5° ± 2. 2°before surgery and 18.0° ±4. 0°at the last follow-up （t = 11. 700 ,P 〈 0. 05 ）. One foot had breakage of the plate and screws at arthrorisis of navieuloeuneiform joint and none had complications related to the incision. Conclusion Operations for Muller-Weiss disease, according to concrete conditions using different therapeutic program, may achieve a satisfactory outcome.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2012年第10期894-897,共4页
Chinese Journal of Surgery
关键词
跗骨
骨坏死
关节融合术
Tarsal bones
Osteonecrosis
Arthrodesis
