Ilizarov外固定架与截骨融合治疗创伤后马蹄足畸形的比较

目的比较Ilizarov外固定架（伊氏架）和截骨融合两种治疗创伤性马蹄足的手术方法。方法选择创伤性马蹄足患者86例,采用截骨融合方法治疗25例,采用伊氏架治疗61例。比较2组术前畸形状态、手术时间、出血量、术后的功能状况及并发症和再手术情况。采用AOFAS评分和VASFA评分评估患者功能恢复情况。结果伊氏架组的跖屈畸形平均52.5°,截骨融合组的跖屈畸形平均47.6°,两组之间没有统计学差异（P=0.739）。术中出血截骨组为（136.2±110.7）ml,伊氏架组为（26.0±35.6）ml,截骨组出血量多于伊氏架组（P〈0.01）。两组手术时间、AOFAS评分、VASFA评分差异均无统计学意义（P〉0.05）。结论 Ilizarov外架和截骨融合两种方法疗效相似,术后功能恢复程度相近,且手术创伤较小。

Comparison of Ilizarov external fixator or ankle osteotomy and arthrodesis in the treatment of posttraumatic equines foot deformity

Objective To compare the effect of Ilizarov external fixator or ankle osteotomy and arthrodesis in the treatment of posttraumatic equines foot deformity.Methods A total of 86 patients were involved in this study,among which 25 patients were treated with triple and/or ankle osteotomy and arthrodesis（OA group）,61 patients were treated with Ilizarov external fixator（IEF group）.AOFAS score and VASFA score were used to evaluate the outcome of treatment.Results The preoperative equines deformity of two group had no significant difference（IEF group was 52.5 degree averagely,OA group was 47.6 degree）.The blood loss of IEF group was significant less than OA group,（26.0±35.6）ml vs（136.2±110.7）ml（P〈0.01）.There were no significant difference between the two groups in operative time,AOFAS score and VASFA score（P〉0.05）.Conclusion The Ilizarov external fixator and osteotomy arthrodesis are both succeful methods to treat traumatic equines foot deformity.The prognosis of both methods are comparable.The operation wound of Ilizarov external fixator is significant lower.