踝关节内翻型骨关节炎患者踝上截骨术后影像学参数变化与临床疗效的相关性分析

doi:10.3969/j.issn.1674-490X.2025.06.003

医学研究与教育 ›› 2025, Vol. 42 ›› Issue (6): 26-33.DOI: 10.3969/j.issn.1674-490X.2025.06.003

• 临床医学 • 上一篇

踝关节内翻型骨关节炎患者踝上截骨术后影像学参数变化与临床疗效的相关性分析

多万发¹,李华²

1.承德医学院研究生学院, 河北承德 067000;
2.衡水市人民医院手足外科, 河北衡水 053000

收稿日期:2025-08-23 发布日期:2025-12-31
通讯作者: 李华(1975—),男,河北衡水人,主任医师,博士,硕士生导师,主要从事手外、足踝方向研究。E-mail: 15343182059@163.com
作者简介:多万发(2000—),男,河北衡水人,医师,在读硕士,主要从事手外、足踝方向研究。 E-mail: 16631818448@163.com
基金资助:
河北省医学科学研究课题计划项目(20210487)

Correlation between radiographic changes and clinical outcomes after supramalleolar osteotomy for varus ankle osteoarthritis

DUO Wanfa¹, LI Hua²

1. Graduate School, Chengde Medical University, Chengde 067000, China; 2. Department of Hand and Foot Surgery, Hengshui People's Hospital, Hengshui 053000, China

Received:2025-08-23 Published:2025-12-31

摘要/Abstract

摘要： 目的探讨踝上截骨术后影像学参数变化与临床疗效之间的相关性。方法回顾性分析2019年1月至2023年8月于衡水市人民医院行踝上截骨术治疗的23例(24足)内翻型踝关节骨关节炎患者资料。比较术前和末次随访踝关节影像学参数;采用美国足踝骨科协会踝与后足评分和疼痛视觉模拟评分评估临床疗效。分析术前和末次随访影像学参数与美国足踝骨科协会踝与后足评分、疼痛视觉模拟评分间的相关性,以及影像学参数变化与美国足踝骨科协会踝与后足评分、疼痛视觉模拟评分变化间的相关性。结果随访时间为(15.25±3.07)个月。术后影像学参数及美国足踝骨科协会踝与后足评分、疼痛视觉模拟评分均较术前有显著改善(P<0.01)。Pearson相关分析显示,术前和末次随访内踝间隙的宽度与美国足踝骨科协会踝与后足评分、疼痛视觉模拟评分显著相关(P<0.05);胫骨远端前侧关节面角和内踝间隙的变化与临床疗效显著相关(P<0.01)。结论踝上截骨术治疗中期内翻型踝关节骨关节炎的疗效肯定,胫骨远端前侧关节面角和内踝间隙的改善与临床疗效呈正相关,上述参数的变化越大,可能预示着越好的临床疗效。

关键词: 踝上截骨术, 影像学参数, 临床疗效, 相关性分析

Abstract: Objective To investigate the correlation between radiographic changes and clinical outcomes after supramalleolar osteotomy(SMOT)for varus ankle osteoarthritis(AA). Methods A retrospective analysis was conducted on 23 patients(24 feet)with varus AA treated with SMOT between January 2019 and August 2023. There were 9 males(9 feet)and 14 females(15 feet), with a mean age of 57.94 years. Radiographic parameters were compared preoperatively and at final follow-up. Clinical outcomes were assessed using the American Orthopedic Foot and Ankle Society(AOFAS)score and Visual Analogue Scale(VAS)for pain. Correlations between radiographic parameters and AOFAS/VAS scores, as well as between changes in radiographic parameters and final scores, were analyzed. Results The mean follow-up was 15.25±3.07 months. All radiographic parameters, AOFAS, and VAS scores showed significant improvement postoperatively(P<0.01). The mean AOFAS score were improved to 81.31±2.73, and VAS decreased to 1.93±0.29. Pearson analysis revealed that medial clear space(MCS)was significantly correlated with AOFAS and VAS scores both preoperatively and at final follow-up(P<0.05). Changes in tibial articular surface angle(TAS)and MCS were significantly correlated with clinical outcomes(P<0.01). Conclusion SMOT provides satisfactory mid-term outcomes for varus AA. Changes in TAS and MCS are important indicators for evaluating clinical efficacy, with greater changes associated with better outcomes.

Key words: supramalleolar osteotomy, radiographic parameters, clinical outcomes, correlation analysis

中图分类号:

多万发,李华. 踝关节内翻型骨关节炎患者踝上截骨术后影像学参数变化与临床疗效的相关性分析[J]. 医学研究与教育, 2025, 42(6): 26-33.

DUO Wanfa, LI Hua. Correlation between radiographic changes and clinical outcomes after supramalleolar osteotomy for varus ankle osteoarthritis[J]. Journal of Hebei Medical College for Continuing Education, 2025, 42(6): 26-33.

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踝关节内翻型骨关节炎患者踝上截骨术后影像学参数变化与临床疗效的相关性分析

Correlation between radiographic changes and clinical outcomes after supramalleolar osteotomy for varus ankle osteoarthritis

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