两种髓内钉行胫距跟关节融合术的疗效比较OA

Objective To compare the efficacy of tibiotalocalcaneal arthrodesis(TTCA)using straight and single-curved intramedullary nails.Methods According to the different types of intramedullary nailing,49 patients under-going TTCA treatment were divided into two groups:straight group(26 cases were treated by TTCA with straight intr-amedullary nail)and single-curved group(23 cases were treated by TTCA with single curved intramedullary nail).The bony healing time of fusion site,joint fusion rate,postoperative complications and pain VAS were compared be-tween the two groups.According to the imaging data,the alignment was evaluated in the patients with abnormal hind-foot alignment(17 cases in each group),and the angle of varus or valgus was measured.Ankle function was evaluated by AOFAS ankle-hindfoot score.Results All patients were followed up for 12～74(42.1±19.9)months.There were no statistical differences in bony healing time of fusion site,joint fusion rate and postoperative complications inci-dence between the two groups(P>0.05).The pain VAS and AOFAS ankle-hindfoot score:At the last follow-up,two groups were better than those before operation(P<0.01),and there was no statistical difference between the two groups at the last follow-up(P>0.05).In 34 patients with abnormal hindfoot alignment,the hindfoot alignment all re-turned to normal,and the comparison of the varus or valgus angles:The last follow-up of both groups was smaller than that before operation(P<0.05),and there was no statistical difference between the two groups at the last follow-up(P>0.05).Conclusions The curative effect is similar for treatment of TTCA with straight intramedullary nail or sin-gle-curved intramedullary nail.Both of them can effectively treat severe ankle joint degeneration and hindfoot deformity.