Objective: To evaluate the early effectiveness of a new minimally invasive plate in the treatment of varus-type ankle arthritis.
Methods: A clinical data of 15 patients with varus-type ankle arthritis who met the selection criteria between March 2021 and October 2021 were retrospectively analyzed. All the patients were treated with medial open-wedge supramalleolar osteotomy and fibular osteotomy. The osteotomies were fixed with the new minimally invasive plate. There were 7 males and 8 females with an average age of 49.8 years (range, 16-71 years). The causes of ankle arthritis included post-fracture deformity in 1 case, sprain in 8 cases, and acquired clubfoot in 1 case; and 5 cases were without obvious factors. The disease duration ranged from 1 to 12 years, with an average of 4.1 years. Comparisons were made between pre-operation and the last follow-up in the Takakura staging, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, foot function index (FFI), visual analogue scale (VAS) score, tibial anterior surface angle (TAS), tibial lateral surface angle (TLS), and talar tilt (TT).
Results: All incisions healed by first intention. All patients were followed up 7-18 months (mean, 12.8 months). At last follow-up, the AOFAS ankle-hindfoot score, FFI, VAS score, and Takakura staging significantly improved when compared with the preoperative ones ( P<0.05). X-ray films showed that the osteotomy healed at 3 months after operation. At last follow-up, TAS significantly increased and TT decreased when compared with the preoperative ones ( P<0.05), and the difference in TLS between pre- and post-operation was not significant ( P>0.05). Complications included 1 case of intraoperative screw breakage and 2 cases of nerve injury of the affected foot. None of the patients complained of significant discomfort at the plate placement during follow-up, and no loosening of the internal fixator occurred. Eleven patients were very satisfied with the effeectiveness, while 4 were relatively satisfied.
Conclusion: The new minimally invasive plate for the varus-type ankle arthritis has good early effectiveness in relieving ankle pain, correcting deformity, improving limb alignment and ankle function, and reducing the incidence of postoperative incisional complications.
目的: 探讨新型微创接骨板治疗内翻型踝关节炎的早期疗效。.
方法: 回顾性分析2021年3月—10月符合选择标准的15例内翻型踝关节炎患者临床资料。患者均行内侧撑开踝上截骨术联合腓骨截骨，采用新型微创接骨板固定截骨。男7例，女8例；年龄16～71岁，平均49.8岁。踝关节炎病因：骨折后畸形愈合1例，扭伤8例，后天马蹄足1例，无明显诱因5例。病程1～12年，平均4.1年。比较手术前后Takakura分期、美国矫形足踝协会（AOFAS）踝-后足评分、足部功能指数（FFI）、疼痛视觉模拟评分（VAS）以及胫骨远端关节面正位角（tibial anterior surface angle，TAS）、距骨倾斜角（talar tilt，TT）、胫骨远端关节面侧位角（tibial lateral surface angle，TLS）。.
结果: 术后切口均Ⅰ期愈合。患者均获随访，随访时间7～18个月，平均12.8个月。末次随访时，AOFAS踝-后足评分、FFI、VAS评分及Takakura分期均较术前改善（ P<0.05）。X线片复查示术后3个月随访时截骨均愈合；末次随访时TAS较术前增大、TT减小，差异均有统计学意义（ P<0.05），而TLS与术前比较差异无统计学意义（ P>0.05）。并发症包括1例术中螺钉断裂，2例患足神经损伤。随访期间患者均未诉放置钢板处明显不适，无内固定物松动发生。患者自评满意度达非常满意11例，比较满意4例。.
结论: 新型微创接骨板用于治疗内翻型踝关节炎具有良好早期疗效，可缓解踝关节疼痛，矫正畸形，改善下肢力线及踝关节功能，且术后切口并发症发生率较低。.
Keywords: Varus-type ankle arthritis; early effectiveness; medial open-wedge osteotomy; new minimally invasive plate.