踝关节缓慢牵伸延长融合术3例病例报道

目的：观察踝关节缓慢牵伸延长融合对陈旧性踝关节损伤的疗效。方法回顾性分析3例陈旧性踝关节损伤患者，均采用踝关节缓慢牵伸延长融合新方法治疗。术中行踝关节截骨、Orthofix外固定支架固定，术后7 d开始踝关节缓慢牵伸延长，至踝关节间隙牵开1～2 cm ，双下肢基本等长时结束，踝关节完全骨性融合后取出外固定支架开始负重行走。结果随访10～23个月，平均16个月。3例患者踝关节平均在术后9个月得到骨性融合并拆除外固定支架。采用美国骨科足踝外科协会（AOFAS）踝关节及后足功能评分，3足平均评分由术前的25．6分提高到术后随访时的76．3分。结论踝关节缓慢牵伸延长融合对陈旧性踝关节损伤是一种新的有效治疗方法。

Three cases report of ankle extension fusion

Objective To observe the effect of ankle slow lengthening fusion on old ankle injury .Methods Totally 3 cases of old ankle injury ,were retrospectively analyzed .The new method of ankle slow lengthening fusion was adopted for conducting treat‐ment .Intraoperative ankle osteotomy and Orthofix external fixation were performed ,ankle slow lengthening was started on postop‐erative 7 d ,and the ankle joint gap was pulled for 1-2 cm ,the double lower limbs were basically equal length and the ankle reached completely bony fusion ,the external fixator was taken out and then weight‐bearing walking started .Results The 10 -23 months follow up was performed ,averaged 16 months .Three cases of ankle joint obtained bony fusion in postoperative 9 months and the ex‐ternal fixator was dismantled .By adopting the AOFAS foot score ,the average score in 3 feet was increased from preoperative 25 .6 points to postoperative 76 .3 points at the time of follow‐up .Conclusion Ankle slow lengthening fusion is an effective treatment method for old ankle joint injury .