변형을 동반한 족근 관절 관절염에 대한 관절 고정술 후 결과

Results of Arthrodesis in Ankle Arthritis with Deformity

  • 박종혁 (전북대학교 의과대학 정형외과학교실) ;
  • 문승진 (전북대학교 의과대학 정형외과학교실) ;
  • 이주홍 (전북대학교 의과대학 정형외과학교실)
  • Park, Jong-Hyuk (Department of Orthopedic Surgery, Chonbuk National University Medical School) ;
  • Moon, Seung-Jin (Department of Orthopedic Surgery, Chonbuk National University Medical School) ;
  • Lee, Ju-Hong (Department of Orthopedic Surgery, Chonbuk National University Medical School)
  • 발행 : 2005.06.01

초록

중등도 이상의 변형을 가진 족근 관절 관절염에 대해 관혈적 관절 고정술은 양호한 결과를 보였으며 경비골 도달법에 의한 관절 고정술이 이상적인 족근 관절의 고정 위치를 얻는데 보다 용이하였다.

Purpose: We reviewed the results of ankle arthritis with advanced deformity treated with open arthrodesis. Materials and Methods: Seventeen patients who had painful ankle arthritis with advanced deformity underwent open arthrodesis using chevron osteotomy or transfibular approach and were followed for an average of 4.2 years (range, 1.5 to 9.7 years). The average age was 51.4 years and the most common cause was traumatic arthritis (13 patients). Postoperative outcome was evaluated using Mazur's grading system for ankle function. we also checked time to union, patient satisfaction, complications, position of arthrodesis and degenerative changes of adjacent joints. Results: Clinical score was improved to 76.4 points from 46.7 points. Average time to union was 4.3 months and the rate of satisfaction was 88%. Complications included 1 nonunion, 2 malunion, 1 superficial infection and 1 combined delayed union and malunion. There were 14 cases within $5^{\circ}$ valgus in frontal plane and 13 cases within neutral to $5^{\circ}$ dorsiflexion in sagittal plane. 3 cases in chevron osteotomy revealed valgus and plantarflexed position over $5^{\circ}$. Degenerative changes of adjacent joints was seen in 2 patients. Conclusion: Open arthrodesis for ankle arthritis with advanced deformity shows favorable clinical outcome. Transfibular approach shows more consistent results than chevron soteotomy for desired position of arthrodesis.

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