CAJ | 학술논문

目的探讨胫骨干骨折伴同侧无移位的后踝骨折的损伤机制与防治. 方法 2001年5月至2004年11月,共收治34例胫骨干骨折伴后踝骨折,2例为开放性骨折.手术前摄胫腓骨全长和踝关节x线片,发现或怀疑有后踝骨折者,均予CT检查,术中先予后踝骨折块经皮螺钉固定,再行胫骨髓内钉手术治疗. 结果所有患者平均随访时间11个月.33例患者骨折愈合良好,踝关节功能优良.1例患者术前漏诊,随访时发现后踝骨折,踝关节疼痛功能差. 结论胫骨干合并后踝骨折在临床常见,后踝骨折漏诊是后期踝关节功能障碍的主要原因,术前踝关节CT检查及术中后踝精确固定是防治的关键.
목적 탐토경골간골절반동측무이위적후과골절적손상궤제여방치. 방법 2001년5월지2004년11월,공수치34례경골간골절반후과골절,2례위개방성골절.수술전섭경비골전장화과관절x선편,발현혹부의유후과골절자,균여CT검사,술중선여후과골절괴경피라정고정,재행경골수내정수술치료. 결과소유환자평균수방시간11개월.33례환자골절유합량호,과관절공능우량.1례환자술전루진,수방시발현후과골절,과관절동통공능차. 결론경골간합병후과골절재림상상견,후과골절루진시후기과관절공능장애적주요원인,술전과관절CT검사급술중후과정학고정시방치적관건.
Objective To discuss the cause and prevention of the tibial shaft fracture associated with ipsilateral posterior malleolus fracture. Methods From May 2001 to November 2004, 269 cases of tibial shaft fracture were treated in our department. Of them, 34 were complicated with ipsilateral posterior nialleolus fracture. They were 21 males and 13 females. Their ages ranged from 33 to 71 years old. There were 2 patients with tibial open fracture. Preoperatively conventional plain X-ray of the full-length tibia and ankle region was taken for all the patients. CT scanning was conducted for those who were suspected of the ipsilateral posterior malleolus fracture. Before tibial intramedulary nailing, the posterior malleolar fragments were fixed with an anterior lag-screw. Results The mean duration of follow-up was 11 months. The posterior malleolus fracture healed with excellent ankle function in 33 cases. The only one case whose posterior malleolus fracture had been overlookd until follow-up sufferd from ankle disfunction and pain. Conclusions The tibial shaft fracture is frequently complicated with and the ipsilateral posterior malleolus fracture in clinic which is re-sponsible for the ankle disfunction. Pre-operative CT scanning of the ankle and fixation of the fragments are key elements of the prevention.