人工跖趾关节置换的临床应用

目的总结应用跖趾关节置换手术治疗足部疾患的临床经验，评价手术治疗效果。方法自2011年3月至2012年6月，我科共有52例足部疾患患者接受跖趾关节置换手术治疗，其间Freiberg病患者28例（35足），合并腮外翻15例（16足）；第1跖趾关节骨关节炎患者18例（20足）；跖趾关节创伤性关节炎患者6例（6足）。均应用Swanson人工关节假体实施跖趾关节置换手术治疗。采用美国足踝外科协会评分系统对手术前后疼痛、行走、穿鞋及跖趾关节活动度等进行临床评价。结果随访时间3—25个月，平均13．4个月。所有病例术后关节疼痛明显改善，活动度改善。通过AOFAS评分评定，所有患者术后较术前有明显改善。结论Swanson人工跖趾关节置换术治疗足部疾患近期疗效满意，能明显改善关节活动度及疼痛，是一种较为可行的术式。

The Application of Artificial Tarsal-matatarsal Joint Arthroplasty

Objective To summarize the clinical experience of tarsal-matatarsal joint arthroplasty treatment of foot disor- ders on metatarsophalangeal joint replacement surgery, and to evaluate the results of the surgical treatments. Methods From March 2011 to June 2012, our department collected eight cases of foot disease who underwent metatarsophalangeal joint re- placement surgery,including 28cases with Freiberg disease, 15 case combined with hallux valgns, 18 cases with the first tarsal- matatarsal joint osteoarthritis, and 6 case with the tarsal-matatarsal joint traumatic arthritis. All the patients were opertated with Swanson prosthesis metatarsophalangeal joint. We evaluated the pain, walking, wearing shoes and range of motion （ ROM ） of the metatarsophalangeal joint by the AOFAS score. Results All the cases were followed up from 3 to 25 months, and the average is 13.4 months. The pain and range of motion（ROM） are significantly improved in all patients. Assessed by AOFAS score, all patients significantly improved compared with that of preoperative. Conclusion Swanson artificial tarsal-matatarsal joint arthroplasty provised a satisfactory short-term effect of foot disorders,which can significantly improve joint mobility and pain and is a more viable surgical.