在Charcot关节部分脱骨术后的Tibiotalocalcaneal融合的结果
Dominick Casciato1, Shehryar Raja2, Korey DuBois3
1*University of Maryland Medical Center, Baltimore, MD.
Journal of the American Podiatric Medical Association
|October 30, 2025
概括
带有小腿骨关节切除的部分切除术为Charcot脚退化提供了有效的治疗方法,最大限度地减少骨切除并避免截肢. 这种方法在初级合并中取得了79%的成功率.
科学领域:
- 整形外科手术 整形外科手术
- 足部医学是一门专业.
- 糖尿病足部并发症 糖尿病足部并发症
背景情况:
- 查克特脚退化,神经病变或其他条件的后续,提出了治疗挑战.
- 传统的治疗方法,如全息切除术是昂贵的,可能会去除可活性的组织.
- 节骨结是截肢前的最后手段,凸显了对替代性手术选择的需要.
研究的目的:
- 为了评估部分切除术结合骨关节切除术治疗Charcot脚的结果.
- 评估该技术在实现稳定的融合和肢体救援方面的有效性.
主要方法:
- 一项回顾性研究包括了19名患有Charcot神经关节病症的患者,这些患者需要tibiotalocalcaneal fusion.
- 该手术涉及使用内部和/或外部固定结构的部分口腔切除术.
- 患者的平均随访时间为22.0±14.8个月.
主要成果:
- 在79%的患者中,成功地实现了带有部分切除术的初级小腿骨关节损伤.
- 伴随性疾病包括骨髓炎 (21%) 和手术部位伤口 (32%).
- 没有患者需要进行重大截肢;通过进一步的小腿骨关节切除术成功管理了修订.
结论:
- 部分切除术是Charcot脚的有效手术选择,最大限度地减少骨切除,同时能够进行一次性关节切除.
- 与全方位切除术相比,这种技术可以保存潜在的可活本地组织.
- 转换为骨关节切除术是部分切除术失败的可行选择,强调在完全切除骨头之前考虑它.
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