前路锁定钢板联合加压螺钉与锁定钢板行踝关节融合的疗效比较

目的:比较运用前路锁定钢板联合加压螺钉与单用锁定钢板行踝关节融合的临床疗效。方法:选择2012年4月至2015年7月收治并符合纳入标准的52例终末期踝关节炎患者,按照不同的手术固定方式分为锁定钢板联合加压螺钉组(A:n=27)和锁定钢板组(B:n=25),记录并比较两组手术时间、关节融合时间、AOFAS评分、术中及术后并发症。结果:两组手术时间比较无明显差异;所有关节最终都获得骨性融合,A组平均骨愈合时间为(13.0±2.1)周,B组为(16.0±4.6)周,较A组明显缩短(P0.01);A组末次随访时平均AOFAS评分为(81.8±5.19)分,B组为(78.3±6.94)分,较A组明显升高(P0.05)。结论:与单用锁定钢板相比,锁定钢板联合加压螺钉用于踝关节融合术可获得更加坚强的固定,有利于患肢早期功能锻炼、负重,缩短骨愈合时间。

A Comparative Study on Anterior Locking Plate Plus Compression Screw Fixation and Anterior Locking Plate Fixation in the Ankle Arthrodesis

Objective:To assess the functional outcome of ankle arthrodesis using either anterior locking plate plus compression screw fixation or anterior locking plate fixation.Methods:We retrospectively analyzed 52 patients with open ankle fusion from April 2012 to July 2015. Of them, 27 were fixated with anterior locking plate plus compression screw fixation (group A) and 25 with anterior locking plate fixation (group B). The 2 groups were compared with respect to operation time, bony fusion time and American Orthopedic Foot and Ankle Society (AOFAS) scores, intra- and postoperative complications.Results:There was no difference in operation time between two group; both groups attained eventual union; The mean time to fusion was (13.0± 2.1) weeks in group A ,significantly (P<0.01) shorter than groupB (16.0± 4.6 weeks); The mean AOFAS score at the final follow-up was (81.8± 5.19) in group A, which is higher than group B (78.3± 6.94)(P<0.05).Conclusion:This study demonstrate that anterior locking plate plus compression screw fixation gives more stable internal stiffness compare to anterior locking plate fixation for ankle arthrodesis, yields improve postoperative rehabilitation, earlier weight bearing and shorter healing time.