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頁籤選單縮合
題 名 | Tuberculosis of the Ankle: Report of Four Cases=踝關節結核病:四例報告 |
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作 者 | 蔡燿鴻; 翁文能; 施俊雄; | 書刊名 | 長庚醫學 |
卷 期 | 21:4 1998.12[民87.12] |
頁 次 | 頁481-486 |
分類號 | 416.61 |
關鍵詞 | 結核病; 滑膜切除術; 關節融合術; Tuberculosis; Synovectomy; Arthrodesis; |
語 文 | 英文(English) |
中文摘要 | 踝關節結核病是相當罕見的疾病,它常與化膿性關節炎混淆,早期病發時,常被當 作扭傷或是急性骨髓炎處理,易被延誤治療。本篇回顧4例踝關節結核病人,他們的足踝為 中度至重度骨關節破壞情形,因被認為是急性骨髓炎,進而接受手術擴創及抗結核藥物5至6 個月治療。其中2位接受關節融合術,另2位接受關節滑膜切除術。經過平均約4年的追蹤, 發現2位施行關節融合術的病例有較好的臨床及放射線照片結果。我們認為對於一個疼痛腫 脹的踝關節應早期鑑別診斷,若有感染現象則要考慮手術,並做活組織切片及細菌培養,以 期分辨結核性及細菌性關節炎。對於有嚴重破壞程度的踝關節,關節融合術會提供一個較好 預後及穩定的關節。 |
英文摘要 | Tuberculosis of the ankle joint is relatively uncommon, and the treatment usually includes chemotherapy, immobilization and non-weight bearing protection. It is easily confused with pyogenic arthritis, which often leads to delayed diagnosis. We reviewed the records of 4 patients with ankle tuberculosis with advanced articular lesions without evidence of pulmonary tuberculosis. They took antituberculous agents for 5 to 6 months. Two of them had positive bacterial cultures, and all four had initially received surgical management under the impression of pyogenic osteomyelitis. Two patients underwent arthrodesis and the other two synovectomy with debirdment. The clinical and radiologic results were better in the patients who underwent arthrodesis. We consider surgery with open biopsy of a painful swelling ankle to be helpful in the differential diagnosis of tuberculous and pyogenic arthritis. Arthrodesis in patients with severe osteoarticular destruction of the ankle provides a better prognosis and more stable joint than other treatment methods. |
本系統中英文摘要資訊取自各篇刊載內容。