[1]刘核达,刘林,黄飞,等.自体带骨膜髂骨移植术治疗距骨骨软骨损伤的疗效观察[J].中国中医骨伤科杂志,2025,33(02):81-85.[doi:10.20085/j.cnki.issn1005-0205.250216]
　LIU Heda,LIU Lin,HUANG Fei,et al.Effect of Autogenous Periosteum Iliac Bone Grafting on Osteochondral Injury of Talus[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(02):81-85.[doi:10.20085/j.cnki.issn1005-0205.250216]
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自体带骨膜髂骨移植术治疗距骨骨软骨损伤的疗效观察()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年02期
页码:
81-85
栏目:
临床报道
出版日期:
2025-02-15

文章信息/Info

Title:
Effect of Autogenous Periosteum Iliac Bone Grafting on Osteochondral Injury of Talus
文章编号:
1005-0205(2025)02-0081-05
作者:
刘核达1; 刘林1; 黄飞1; 李鹏伟1; 李明1; 刘胜1; 李森田1
1河北省沧州中西医结合医院(河北 沧州,061013)
Author(s):
LIU Heda1; LIU Lin1; HUANG Fei1; LI Pengwei1; LI Ming1; LIU Sheng1; LI Sentian1
1Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province,Cangzhou 061013,Hebei China.
关键词:
距骨骨软骨损伤;  自体带骨膜髂骨移植术;  踝关节功能;  疼痛;  并发症
Keywords:
osteochondral lesion of the talus;  autologous transplantation of iliac bone with periosteum;  ankle joint function;  pain;  complications
分类号:
R687.3
DOI:
10.20085/j.cnki.issn1005-0205.250216
文献标志码:
B
摘要:
目的:分析自体带骨膜髂骨移植术对距骨骨软骨损伤(OLT)患者影像学检查结果和踝关节功能的影响。方法:选择2018年1月至2022年11月收治的距骨骨软骨损伤122例患者病例资料,均行自体带骨膜髂骨移植术,比较患者术前和术后关节活动度、关节功能、关节疼痛程度及并发症情况。结果:患者术后6个月总有效率(82.79%)显著低于术后12个月(93.44%),差异有统计学意义(P<0.05); 术后6个月和12个月主动屈伸关节活动度(ROM)、踝-后足评分系统(AOFAS)总分显著高于术前,差异有统计学意义(P<0.05),视觉模拟量表(VAS)评分显著低于术前,差异有统计学意义(P<0.05); 且患者术后12个月关节活动度水平和AOFAS评分显著高于术后6个月,差异有统计学意义(P<0.05),VAS评分显著低于术后6个月,差异有统计学意义(P<0.05); 患者术后影像学检查结果显示距骨软骨下囊肿消失,移植区无异常,均未发生不良反应。结论:距骨骨软骨损伤患者自体带骨膜髂骨移植术治疗,可控制病情发展,有助于踝关节功能恢复,降低疼痛程度,效果较为理想,临床应用价值较高。
Abstract:
Objective:To explore and analyze the impacts of autologous periosteal iliac bone transplantation on imaging results and ankle joint function in patients with osteochondral lesion of the talus(OLT).Methods:A total of 122 OLT patients admitted from January 2018 to November 2022 were selected,all of whom underwent autologous periosteal iliac bone transplantation.The preoperative and postoperative joint range of motion(ROM),joint function,degree of joint pain,and complications of patients were compared.Results:The total effective rate of patients at 6 months post surgery(82.79%)was obviously lower than that at 12 months post surgery(93.44%)(P<0.05); after 6 and 12 months of surgery,the total scores of active flexion and extension joint ROM and ankle hind foot scoring system(AOFAS)were obviously higher than before surgery(P<0.05),and the total score of visual analogue scale(VAS)was obviously lower than before surgery(P<0.05); moreover,the ROM level and AOFAS score of the patients were obviously higher at 12 months post surgery than at 6 months post surgery(P<0.05),while the VAS score was obviously lower at 6 months post surgery(P<0.05); and the postoperative imaging results of the patient showed that the subchondral cyst of the talus disappeared,there were no abnormalities in the transplantation area,and no adverse reactions occurred.Conclusion:Autologous transplantation of iliac bone with periosteum can effectively control the progression of OLT patients,aid in ankle joint function recovery,reduce pain levels,and achieve ideal results,with high clinical application value.

参考文献/References:

[1] 谢国鑫,刘金豹,梁学振,等.距骨骨软骨损伤的手术治疗研究进展[J].医学综述,2021,27(7):1363-1368.
[2] 崔明星,刘洋,程明子,等.不同手术方式治疗Hepple Ⅴ型距骨骨软骨损伤的临床疗效[J].新乡医学院学报,2021,38(1):36-40.
[3] 王建超,胡秀良,苗旭东,等.自体带骨膜髂骨植骨联合螺钉内固定治疗距骨软骨损伤[J].中医正骨,2019,31(9):71-73.
[4] 陈文,田莉,刘涛,等.经内踝截骨自体膝关节软骨移植治疗距骨骨软骨损伤伴囊肿21例[J].中国中医骨伤科杂志,2024,32(3):79-82.
[5] 沈云龙,戴季林,沈占英,等.踝关节镜下微骨折手术联合玻璃酸钠治疗距骨骨软骨损伤的临床观察[J].中国生化药物杂志,2017,37(7):216-217.
[6] 李雅娟,杨登军,宁梓文,等.两种内踝截骨术在治疗Hepple Ⅴ期距骨骨软骨损伤中的疗效对比[J].云南医药,2023,44(3):16-19.
[7] 李海鹏,朱娟丽,魏钰,等.自体带骨膜髂骨移植治疗Hepple Ⅴ型距骨骨软骨损伤的临床疗效[J].中国运动医学杂志,2021,40(1):3-6.
[8] 邓恩,史尉利,郭秦炜.距骨骨软骨损伤的诊断与治疗研究进展[J].中国运动医学杂志,2019,38(4):336-342.
[9] 于胜文,常锦磊,纪金斗,等.带骨膜髂骨移植治疗距骨骨软骨损伤13例疗效分析[J].中国中医骨伤科杂志,2020,28(4):72-75.
[10] 温纪林,李莹.距骨骨软骨损伤的研究进展[J].骨科临床与研究杂志,2023,8(3):179-186.
[11] 吴留生.距骨骨软骨损伤采用踝关节镜下微骨折手术及自体骨软骨移植术的疗效对比[J].数理医药学杂志,2020,33(5):678-679.
[12] 刘核达,黄飞,刘林,等.独活寄生汤联合自体带骨膜髂骨移植治疗Hepple Ⅴ期距骨骨软骨损伤疗效观察[J].河北中医,2023,45(10):1601-1604.
[13] 何伟,吕佐,杨万雷,等.自体带骨膜髂骨移植术治疗Hepple Ⅴ型距骨骨软骨损伤的疗效分析[J].中国骨与关节损伤杂志,2021,36(10):1031-1034.
[14] 刘占宗,曲家富,张波.带骨膜的自体胫骨远端松质骨植骨治疗Hepple Ⅲ-Ⅳ型距骨软骨损伤[J].中国骨伤,2018,31(11):1061-1064.
[15] 毛丰.关节镜微骨折手术与自体骨软骨移植手术治疗距骨骨软骨损伤的临床疗效[J].检验医学与临床,2019,16(17):2518-2521.
[16] WOELFLE J V,REICHEL H,NELITZ M.Indications and limitations of osteochondral autologous transplantation in osteochondritis dissecans of the talus[J].Knee Surg Sports Traumatol Arthrosc,2013,21(8):1925-1930.
[17] 刘林,杨宗宇,刘核达,等.自体带骨膜髂骨移植联合PRP治疗Hepple Ⅴ期距骨骨软骨损伤[J].中国矫形外科杂志,2021,29(2):154-157.
[18] 刘斌,邹毅,冷华伟,等.关节镜下微骨折术与自体骨软骨移植术治疗距骨骨软骨损伤比较[J].延安大学学报(医学科学版),2022,20(2):39-43.
[19] 史雪峰,唐翔宇,项毅,等.髂骨带骨膜移植治疗距骨骨软骨损伤的临床疗效[J].实用骨科杂志,2022,28(4):370-372.
[20] 马永刚,雷云峰,常彦海,等.自体带骨膜髂骨移植对距骨软骨损伤的临床疗效观察[J].西南国防医药,2018,28(10):952-954.
[21] 崔明星,刘洋,程明子,等.自体带骨膜髂骨移植治疗Hepple Ⅴ型距骨骨软骨损伤的中短期效果[J].河南医学研究,2020,29(23):4248-4251.

备注/Memo

备注/Memo:
基金项目:河北省中医药管理局2020年度中医药类科研计划项目(2020508)
更新日期/Last Update: 2025-02-15