| 单纯距舟融合结合舟骨应力调整对Müller-Weiss病畸形的临床疗效 |
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投稿时间：2024-11-26
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| 作者 | Author | 单位 | Address | E-Mail |
| 庄新凯 |
ZHUANG Xin-kai |
浙江中医药大学附属江南医院, 浙江 杭州 311200 |
Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 311200, Zhejiang, China |
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| 辛大伟 |
XIN Da-wei |
浙江中医药大学附属江南医院, 浙江 杭州 311200 |
Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 311200, Zhejiang, China |
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| 曾林如 |
ZENG Lin-ru |
浙江中医药大学附属江南医院, 浙江 杭州 311200 |
Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 311200, Zhejiang, China |
a15106347401@163.com |
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| 期刊信息：《中国骨伤》2025年，第38卷，第4期，第424-429页 |
| DOI：10.12200/j.issn.1003-0034.20240180 |
| 基金项目:浙江省中医药科技计划项目(编号:2023ZL605) |
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中文摘要:
目的: 探讨单纯距舟关节融合结合舟骨应力调整对具有显著平足畸形的Müller-Weiss病的中期疗效。
方法: 自2016年1月至2021年3月,采用单纯距舟关节融合术结合舟骨应力调整治疗Müller-Weiss病患者13例,其中男5例,女8例;年龄47~67岁;病程8~20年;根据Maceira分期:Ⅲ期5例,Ⅳ期8例。比较术前和术后10个月美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)中足评分、视觉模拟评分(visual analogue scale,VAS)、足长变化。比较术前和术后6个月距舟覆盖角、正位距骨-第1跖骨角、跟骨倾斜角变化情况。
结果: 13例患者获得随访,时间24~40个月。所有患者在3~6个月内达到临床愈合标准,1例出现螺钉断裂。VAS由术前的3~7分,降至术后10个月的0~2分;AOFAS中足评分由术前的12~66分,提高至术后10个月的72~100分;术后10个月根据AOFAS中足评分,优3足,良6足,可4足。距舟覆盖角、正位距骨-第1跖骨角、跟骨倾斜角分别由术前的14.3°~33.4°、-4.6°~-19.6°、3.0°~16.4°,改善至术后6个月的2.7°~9.6°、-8.4°~1.1°、18.8°~24.9°。术后10个月时足长增加0~6 mm。
结论: 单纯距舟融合结合舟骨应力调整对Müller-Weiss病在畸形、足长、足功能以及疼痛方面有较满意的临床疗效。 |
| 【关键词】足 舟骨 骨坏死 关节融合术 |
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| Clinical efficacy of talonavicular arthrodesis combined with navicular stress adjustment in Müller-Weiss disease |
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ABSTRACT
Objective To evaluate the mid term efficacy of talonavicular joint fusion alone combined with navicular stress adjustment in Müller-Weiss disease with significant paradoxical flatfoot deformity.
Methods Between January 2016 and March 2021,a total of 13 patients diagnosed with Müller-Weiss disease underwent simple talonavicular joint fusion combined with navicular stress adjustmentadjustment.Among them,5 patients were male and 8 patients were female;age ranged from 42 to 67 years old. The duration of the disease ranged from 8 to 20 years. According to Maceira staging system,5 patients were in stage III and 8 patients were in stage IV. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score,visual analogue scale (VAS),and foot length were evaluated preoperatively and 10 months postoperatively. Additionally,the talonavicular coverage angle,the talus first metatarsal angle,and the calcaneal inclination angle were assessed preoperatively and 6 months postoperatively.
Results All 13 patients were followed up a period ranging from 24 to 40 months. All patients achieved clinical healing within a period of 3 to 6 months. However,one patient experienced a screw fracture. The VAS decreased from a range of 3 to 7 points preoperatively to a range of 0 to 2 points at the 10 months postoperative. The AOFAS midfoot score improved from a preoperative range of 12 to 66 points to a range of 72 to 100 points at the 10 months postoperative. Based on the AOFAS midfoot score evaluated at 10 months postoperatively,the outcomes were rated as excellent in 3 feet,good in 6 feet,and fair in 4 feet. The talo navicular coverage angle,the preoperative talus first metatarsal angle,calcaneal inclination angle were 14.3° to 33.4°,-4.6° to -19.6°,and 3.0°to 16.4° respectively. Six months postoperatively,these angles improved to 2.7°to 9.6°, -8.4°to 1.1°,and 18.8°to 24.9°respectively. Additionally,the foot length increased by 0 to 6 mm at 10 months post surgery.
Conclusion Simple talonavicular arthrodesis combined with scaphoid stress adjustment has satisfactory clinical efficacy in Müller-Weiss disease in terms of deformity,foot length,foot function and pain. |
| KEY WORDS Foot Navicular bone Osteonecrosis Arthrodesis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 庄新凯,辛大伟,曾林如.单纯距舟融合结合舟骨应力调整对Müller-Weiss病畸形的临床疗效[J].中国骨伤,2025,38(4):424~429 |
| 英文格式: | ZHUANG Xin-kai,XIN Da-wei,ZENG Lin-ru.Clinical efficacy of talonavicular arthrodesis combined with navicular stress adjustment in Müller-Weiss disease[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(4):424~429 |
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