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題 名 | Subtalar Arthrodesis for Subtalar Arthritis=距骨下融合術應用於距骨下關節炎 |
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作 者 | 黃鵬如; 陳勝凱; 陳銀旺; 鄭裕民; 林森源; 許崇義; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷 期 | 13:11 1997.11[民86.11] |
頁 次 | 頁677-681 |
分類號 | 416.61 |
關鍵詞 | 距骨下融合術; 距骨下關節炎; Subtalar arthritis; Subtalar arthrodesis; |
語 文 | 英文(English) |
中文摘要 | 原發性距骨下關節炎並不常見,除非是廣泛性的類風濕關節炎。大部分距骨下關節炎是跟骨骨折的後遺症,融合術似乎是解決此問題的唯一方法。在高醫附設中和紀念醫院共有13個病人 (15隻腳) 接受距骨下融合術,其中11個病人 (13隻腳) 是創傷後距骨下關節炎;1個病人是距骨下類風溼關節炎,1個病人是原發性距骨下退化關節炎。平均追蹤期是24.9個月。手術使用外側皮膚切開,腓骨不做切骨術,如果有壓迫症候群則做骨切除術予以減壓,最後融合處以U型釘做固定。11個病人 (85%) 對結果表示滿意。客觀評估,有11隻腳 (73%) 是優,3隻腳(20%)是良或普通,1隻腳 (7%) 是差,並沒有不黏合的病例。有兩個病人產生併發症,1個是有淺層傷口感染,另一個則發生了U型釘鬆脫現象。雖然沒有不黏合病例發生,但所需融合時間較長,這可能與staple固定沒有辦法提供加壓力量有關。我們認為單純的距骨下關節炎,如果距骨舟骨關節和跟骨骰骨關節都健康的話,只做距骨下融合術就足夠,否則就需要做三關節融合術。 |
英文摘要 | Primary subtalar arthritis Is not common except In cases of generalized arthritis such as rheumatoid arthritis. The majority of subtalar arthritis results f rom tntraarticular calcaneal fractures. Arthrodests seems to be the only way to solve this problem. Thirteen patients (15 feet) were treated with subtalar arthrodesis at KMCH. Preoperative diagnosis Included 13 feet with traumatic arthritis secondary to a calcaneal fracture, one foot with rheumatoid arthritis and one foot with primary osteoarthritis. The mean follow up period was 24.9 months. Lateral approach without fibular osteotomy was done with decompression If there was entrapment syndrome and the arthrodests were accomplished with use of staples for Internal fixation. Eleven (85%) of the patients were satisfied with the results. Objectively, the results were excellent after 11 arthrodesis (73%), good or fair after three (20%), and poor after one (7%). There was no nonunion. Complications occurred In 1 patient who developed superficial wound Infection, and in 1 patient with staple loosening. Though there was no case of nonunion, the fusion time was rather long. This might have been due to the fixation method because staples can not provide compression force which accelerates union. We believe subtalar arthrodests Is appropriate for Isolated subtalar arthritis unless there are associated talonavicular or calcaneocubold arthritis In which case triple arthrodests will be more appropriate. |
本系統中英文摘要資訊取自各篇刊載內容。