中国修复重建外科杂志2024,Vol.38Issue(4) :493-497.DOI:10.7507/1002-1892.202401007

距骨缺血性坏死的手术治疗研究进展

Research progress in surgical treatment of avascular necrosis of talus

张涛 李振豪 崔焱 熊婉琦 王泽文 何挺 刘家河 许静宜 刘保一 杨帆
中国修复重建外科杂志2024,Vol.38Issue(4) :493-497.DOI:10.7507/1002-1892.202401007

距骨缺血性坏死的手术治疗研究进展

Research progress in surgical treatment of avascular necrosis of talus

张涛 1李振豪 1崔焱 1熊婉琦 1王泽文 1何挺 1刘家河 1许静宜 1刘保一 1杨帆1
扫码查看

作者信息

  • 1. 大连大学附属中山医院骨科(辽宁大连 116001)
  • 折叠

摘要

目的 对距骨缺血性坏死手术治疗研究进展进行综述.方法 广泛查阅近年来国内外距骨缺血性坏死相关文献,从发病机制、手术治疗方式及预后等方面进行总结.结果 距骨缺血性坏死早期临床症状不明显,患者就诊时大多已进展至Ficat-Arlet Ⅲ~Ⅳ期,需要手术治疗.目前,该病手术治疗方法主要包括髓芯减压、带血管蒂骨瓣移植、关节置换术及关节融合术等.早期距骨缺血性坏死可保守治疗,如治疗失败可以考虑髓芯减压.关节融合术应作为终末期骨关节炎和塌陷患者的补救手术,存在严重骨丢失时需行胫距跟融合术和植骨.带血管蒂骨瓣移植效果良好,对各期距骨缺血性坏死均有一定治疗效果,但合适骨瓣供区仍需进一步研究.结论 距骨缺血性坏死手术方法以及不同分期治疗体系均有待完善.

Abstract

Objective To summarize the surgical treatment methods for avascular necrosis of the talus.Methods The recent domestic and international literature related to avascular necrosis of the talus was extensively conducted.The pathogenesis,surgical treatment methods,and prognosis were summarized.Results The clinical symptoms of avascular necrosis of the talus at early stage are not obvious,and most patients have progressed to Ficat-Arlet stages Ⅲ-Ⅳ and require surgical treatment.Currently,surgical treatments for this disease include core decompression,vascularized bone flap transplantation,arthroplasty,and arthrodesis,etc.Early avascular necrosis of the talus can be treated conservatively,and if treatment fails,core decompression can be considered.Arthrodesis is a remedial surgery for patients with end-stage arthritis and collapse,and in cases of severe bone loss,tibiotalocalcaneal arthrodesis and bone grafting are required.Vascularized bone flap transplantation is effective and plays a role in all stages of avascular necrosis of the talus,but the appropriate donor area for the flap still needs further to be studied.Conclusion The surgical treatment and the system of treatment for different stages of avascular necrosis of the talus still need to be refined.

关键词

距骨缺血性坏死/手术/带血管蒂骨瓣移植/关节置换/关节融合

Key words

Avascular necrosis of talus/surgery/vascularized bone flap transplantation/arthroplasty/arthrodesis

引用本文复制引用

基金项目

大连市博士后科学基金(285395)

大连医学科学研究项目(2111038)

辽宁省教育厅重点攻关项目(LJKZZ20220148)

大连市科技人才创新支持政策项目(2023RQ034)

大连市科技局科技惠民项目(2023JJ13SN056)

出版年

2024
中国修复重建外科杂志
中国康复医学会,四川大学华西医院

中国修复重建外科杂志

CSTPCD北大核心
影响因子:1.239
ISSN:1002-1892
参考文献量36
段落导航相关论文