摘要
由於踝關節黏合後，可以消除疼痛，而且功能喪失不多，所以踝關節炎的選擇。從1987年1月到1990年12月，本院所作的踝關節黏合術有45例接受追蹤檢查，其中27例男性，18例女生；年齡從18歲到70歲，平均41.9歲，踝關節炎之成因有19例是傷後關節炎，3例風濕性關節炎，7例退化性關節炎，9例感染性關節炎(包括4例細菌感染及5例結核菌感染)2例距骨缺血性壞死，1例charcot 關節炎。手術技法包括34例改良的Blair’s方法，7例加壓外固定術，4例U型骨釘固定。追蹤期間從17個月至52個月，平均28.6個月。其中有兩例由於感染無法控制，最後採取截肢手術。而有兩例關節未黏合，其中有一例接受再度手術。有一些病例因關節黏合慢(超過六個月未黏合)，致平均踝關節黏合時間為5.6個月(從2個月到12個月不等)。如果剔除截肢及未黏合之病例，所有的患者在功能評估上均有進步，而85.3%的患者對其黏合後之踝關節狀況感到滿意。使用改良的Blair’s法可有效的治療各種成因的踝關節炎，但對感染性關節炎來說，使用外固定加壓的黏合方法是較佳的選擇。踝關節固定的位置與是否足關節有代償性的增加活動是影響踝關節黏合術後功能結果很重要的因素。
關鍵字
無資料並列摘要
As a fused ankle provides a painless ankle joint with limited functional disability, ankle arthrodesis is still the treatment of choice for most disabling nakle arthritis. From January 1987 to December 1990, 45 cases of nakle arthordesis were perormed, including 27 male and 18 female patients, aged from 18 to 70 years with and average of 41.9 years. The causes leading to arthrodesis included 19 cases of post-traumatic arthritis, 3 rheumatoid arthritis, 7 osteoarthritis, 9 ankle infections (4 pyogenic and 5 tuberculosis), 4 ankle deformities, 2 avascular necrosis of the talus and 1 cases of Charcot joint. The methods included modified Blair’s ankle arthrodesis (34 cases), compression arthodesis (7 cases) either by Hoffman external fixation or trangular compression device, and intra articular arthrodesis by staple fixation (4 cases). The follow up period ranged from 17 Ms to 52 Ms with an average of 28.6 Ms. There were 2 cases who ultimately required amputation due to uncontrollable infection, and 2 cases of nonunion and one of them received refusion. There were 11 cases of delayed union (union time more than 6 Ms). The average union time was 5.6 Ms, ranging from 2 Ms to 10 Ms. Excluding the cases of amputation and nonunion , all patients had improvement in the ankle functional scale evaluation and 85.3% of the pateients were satisfied with their present condition. The modified Blair’s method of ankle arthrodesis had proven to be an effective method for treating ankle arthritis no matter what the cause. However, for cases of infection, compression arthrodesis with an external fixational device is superior. The fusion position and compensatory hyper-mobility of tarsal joints are the important factors that influence the functional result of ankle arthrodesis.