Ilizarov环固定器关节融合术治疗严重踝关节关节炎

Q3 Medicine Genij Ortopedii Pub Date : 2023-08-30 DOI:10.18019/1028-4427-2023-29-4-362-367
S. V. Yadkikar, V. Yadkikar, R. K. Prasad, R. Grover, A. Ojha
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We describe our experience in Ilizarov ring fixator application for ankle arthrodesis in 5 patients with severe ankle arthritis and their functional outcome.Materials and Methods This retrospective study was conducted in 5 ankle arthrodesis cases using the Ilizarov ring fixator application from July 2021 to October 2022 in the department of orthopaedics, Jaipur national university, India. Average age of patient was 52 years (range, 40-65). Among included patients one patient had chronic osteomyelitis of the distal tibia and severe arthrosis of the ankle joint with a non-healing ulcer, two patients had post-traumatic arthrosis following talus and distal tibia plafond fracture, Charcot ankle arthropathy and tuberculosis of the ankle joint was detected in two patients respectively. Postoperative pain relief, deformity correction and radiological union at the fusion site were defined as success.Results Fusion was achieved in all patients (100%). Early post-operative ambulation and full weight-bearing was initiated in every case. Pin-tract infection was the commonest complication. Shortening due to arthrodesis was less than 2.5 cm so limb lengthening was not done. Frame removal time was 12 to 14 weeks (average time, 13 weeks). Visual analogue scale was used in all cases. It was in the range of 2 to 3 points preoperatively and 7 to 9 post-operatively after arthrodesis. Average follow-up period was 6 months and it is still underway. AOFAS score was used for functional assessment.Conclusion Ilizarov ring fixator application can be considered as versatile, biomechanically stable, minimally invasive method for ankle arthrodesis in severe ankle arthritis associated with poor soft tissue condition, post- traumatic arthritis, infection, deformity, bone loss, Charcot arthropathy.","PeriodicalId":37426,"journal":{"name":"Genij Ortopedii","volume":"29 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Arthrodesis with the Ilizarov ring ffxator for severe ankle arthritis\",\"authors\":\"S. V. Yadkikar, V. Yadkikar, R. K. Prasad, R. Grover, A. Ojha\",\"doi\":\"10.18019/1028-4427-2023-29-4-362-367\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction End-stage ankle arthritis is a very painful and disabling pathology, associated with deformity. 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引用次数: 0

摘要

终末期踝关节关节炎是一种非常痛苦和致残的病理,与畸形有关。感染、皮肤状况不佳、长期吸烟、沙氏关节病不仅影响治疗方法的选择,而且影响愈合,导致不幸截肢。踝关节融合术适用于晚期踝关节关节炎。关节融合术有多种固定方法,从内固定到外固定。Ilizarov环形固定器是一种动态通用的固定方法。它是一种生物力学稳定且微创的方法,可促进骨愈合,并具有启动早期负重和同时矫正畸形的优势。我们描述了我们在5例严重踝关节关节炎患者踝关节融合术中应用Ilizarov环固定器的经验和他们的功能结果。材料与方法回顾性研究2021年7月至2022年10月在印度斋浦尔国立大学骨科应用Ilizarov环固定器进行的5例踝关节融合术。患者平均年龄52岁(范围40-65岁)。纳入的患者中,1例为胫骨远端慢性骨髓炎,2例为严重踝关节关节病伴不愈合溃疡,2例为距骨及胫骨远端平台骨折后的创伤后关节病,2例分别为沙尔科踝关节病和踝关节结核。术后疼痛缓解、畸形矫正和融合部位放射愈合被定义为成功。结果所有患者均成功融合(100%)。所有病例术后均开始早期下床和完全负重。针道感染是最常见的并发症。关节融合术导致的短缩小于2.5 cm,因此未进行肢体延长。取框时间12 ~ 14周,平均13周。所有病例均采用视觉模拟量表。术前2 ~ 3分,关节融合术后7 ~ 9分。平均随访期为6个月,目前仍在进行中。采用AOFAS评分进行功能评估。结论Ilizarov环固定器应用于伴有软组织不良、创伤后关节炎、感染、畸形、骨质流失、沙尔科关节病的严重踝关节关节炎,是一种多功能、生物力学稳定、微创的踝关节固定术。
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Arthrodesis with the Ilizarov ring ffxator for severe ankle arthritis
Introduction End-stage ankle arthritis is a very painful and disabling pathology, associated with deformity. Infection, poor skin condition, chronic smoking, Charcot arthropathy may not only affect selection of treatment method but also union, leading to unfortunate amputation. Ankle arthrodesis is indicated in advanced ankle arthritis. A variety of fixation methods are available for arthrodesis ranging from internal to external fixation. The Ilizarov ring fixator is a dynamic versatile fixation method. It is a biomechanically stable and minimally invasive method which promotes bone union and has advantage of initiating early weight-bearing and simultaneous deformity correction. We describe our experience in Ilizarov ring fixator application for ankle arthrodesis in 5 patients with severe ankle arthritis and their functional outcome.Materials and Methods This retrospective study was conducted in 5 ankle arthrodesis cases using the Ilizarov ring fixator application from July 2021 to October 2022 in the department of orthopaedics, Jaipur national university, India. Average age of patient was 52 years (range, 40-65). Among included patients one patient had chronic osteomyelitis of the distal tibia and severe arthrosis of the ankle joint with a non-healing ulcer, two patients had post-traumatic arthrosis following talus and distal tibia plafond fracture, Charcot ankle arthropathy and tuberculosis of the ankle joint was detected in two patients respectively. Postoperative pain relief, deformity correction and radiological union at the fusion site were defined as success.Results Fusion was achieved in all patients (100%). Early post-operative ambulation and full weight-bearing was initiated in every case. Pin-tract infection was the commonest complication. Shortening due to arthrodesis was less than 2.5 cm so limb lengthening was not done. Frame removal time was 12 to 14 weeks (average time, 13 weeks). Visual analogue scale was used in all cases. It was in the range of 2 to 3 points preoperatively and 7 to 9 post-operatively after arthrodesis. Average follow-up period was 6 months and it is still underway. AOFAS score was used for functional assessment.Conclusion Ilizarov ring fixator application can be considered as versatile, biomechanically stable, minimally invasive method for ankle arthrodesis in severe ankle arthritis associated with poor soft tissue condition, post- traumatic arthritis, infection, deformity, bone loss, Charcot arthropathy.
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来源期刊
Genij Ortopedii
Genij Ortopedii Medicine-Surgery
CiteScore
0.70
自引率
0.00%
发文量
104
审稿时长
12 weeks
期刊介绍: Journal’s main goal is to contribute to the development of the contemporary medical science via presentation of fundamental and applied original scientific studies to the scientific and practical medical community that would widen and deepen the understanding of the most important problems in the field of traumatology, orthopaedics, and related specialties. Our journal provides a direct open access to its content which is based on the principle that the open access option promotes global exchange of knowledge and experience. Journal’s strategy: -Development of the journal as a scientific platform for researchers, doctors, post-graduates and residents -Attraction of highly-cited authors to publish their studies -Selection of manuscripts of scientific interest for readers that will impact on journal citation index in RINC -Increase in the portion of publications submitted by foreign authors and studies conducted in association with foreign scientists; growth of citations in the journals that are included into global systems of indexing and reputable databases -Improvement of the Journal’s web site in two languages for a greater accessibility by authors and readers -Introduction of the Journal into global indexing systems
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