PDF(Pubmed)
Abstract：
BACKGROUND: Charcot arthropathy is a progressive disorder of the ankle and foot joints that can lead to foot deformity and instability. Surgical intervention is often necessary for deformity and ulcer management during the chronic phase. The device used for arthrodesis remains a challenge.
METHODS: This clinical trial study included diabetic patients aged 40 years or older with Charcot foot. Lateral approach with lateral malleolar osteotomy was used to access the ankle joints and remove the cartilage. A small incision was made on the plantar aspect of the foot to pass an appropriately sized intramedullary nail. Demographic information, medical history, surgical details and Clinical data were collected at 2-week and 1-year follow-ups using the Ankle-Hindfoot Scale (AOFAS) score and the EuroQol 5-Dimensional 5-Level (EQ-5D-5L) health utility score.
RESULTS: Twenty-six patients with a mean age of 63 ± 0.23 years were included in the study. The findings showed significant improvements in AOFAS questionnaire items related to pain score, length of the walk, walking surfaces, walking disorders, sagittal alignment, back leg alignment, sustainability, alignment and the total score (P value < 0.001). The EQ-5D-5L questionnaire also showed a significant improvement in the total score (P value = 0.002).
CONCLUSIONS: This study provides evidence supporting the effectiveness of tibiotalocalcaneal arthrodesis by hindfoot nailing in diabetic patients with Charcot foot joints and demonstrated comparable and superior outcomes in terms of patient satisfaction and complication rate when compared to previous studies.
METHODS: This clinical trial study included diabetic patients aged 40 years or older with Charcot foot. Lateral approach with lateral malleolar osteotomy was used to access the ankle joints and remove the cartilage. A small incision was made on the plantar aspect of the foot to pass an appropriately sized intramedullary nail. Demographic information, medical history, surgical details and Clinical data were collected at 2-week and 1-year follow-ups using the Ankle-Hindfoot Scale (AOFAS) score and the EuroQol 5-Dimensional 5-Level (EQ-5D-5L) health utility score.
RESULTS: Twenty-six patients with a mean age of 63 ± 0.23 years were included in the study. The findings showed significant improvements in AOFAS questionnaire items related to pain score, length of the walk, walking surfaces, walking disorders, sagittal alignment, back leg alignment, sustainability, alignment and the total score (P value < 0.001). The EQ-5D-5L questionnaire also showed a significant improvement in the total score (P value = 0.002).
CONCLUSIONS: This study provides evidence supporting the effectiveness of tibiotalocalcaneal arthrodesis by hindfoot nailing in diabetic patients with Charcot foot joints and demonstrated comparable and superior outcomes in terms of patient satisfaction and complication rate when compared to previous studies.
摘要：
背景：Charcot关节病是踝关节和足关节的进行性疾病，可导致足畸形和不稳定。在慢性期的畸形和溃疡处理通常需要手术干预。用于关节固定术的设备仍然是一个挑战。
方法：这项临床试验研究包括40岁或以上的Charcot足糖尿病患者。使用外侧踝骨切开术的外侧入路进入踝关节并去除软骨。在脚的足底方面做一个小切口，以通过适当大小的髓内钉。人口统计信息,病史,在2周和1年随访时,我们使用踝关节-后足量表(AOFAS)评分和EuroQol5维5级(EQ-5D-5L)健康效用评分收集手术细节和临床数据.
结果：本研究纳入了26例患者，平均年龄为63±0.23岁。结果显示，与疼痛评分相关的AOFAS问卷项目有显著改善，步行的长度，行走表面，行走障碍,矢状对齐,后腿对齐,可持续性比对和总分（P值<0.001）。EQ-5D-5L问卷也显示总分的显著提高(P值=0.002)。
结论：本研究提供了证据，证明了在Charcot足关节糖尿病患者中通过后足钉固定胫骨骨关节融合术的有效性，并且与以前的研究相比，在患者满意度和并发症发生率方面具有可比性和优越性。
方法：这项临床试验研究包括40岁或以上的Charcot足糖尿病患者。使用外侧踝骨切开术的外侧入路进入踝关节并去除软骨。在脚的足底方面做一个小切口，以通过适当大小的髓内钉。人口统计信息,病史,在2周和1年随访时,我们使用踝关节-后足量表(AOFAS)评分和EuroQol5维5级(EQ-5D-5L)健康效用评分收集手术细节和临床数据.
结果：本研究纳入了26例患者，平均年龄为63±0.23岁。结果显示，与疼痛评分相关的AOFAS问卷项目有显著改善，步行的长度，行走表面，行走障碍,矢状对齐,后腿对齐,可持续性比对和总分（P值<0.001）。EQ-5D-5L问卷也显示总分的显著提高(P值=0.002)。
结论：本研究提供了证据，证明了在Charcot足关节糖尿病患者中通过后足钉固定胫骨骨关节融合术的有效性，并且与以前的研究相比，在患者满意度和并发症发生率方面具有可比性和优越性。
