CAJ | 학술논문

目的探讨足舟状骨体骨折脱位合并骰骨骨折的治疗方法与临床疗效.方法对2005年3月至2010年3月收治的17例闭合性足舟状骨体骨折脱位合并骰骨骨折患者的临床资料进行回顾性研究;男12例,女5例;年龄17～63岁,平均40岁.舟骨骨折按照Sangeorzan分型:Ⅱ型5例,Ⅲ型12例,骰骨骨折按照AO分型:C1型3例,C2型14例.17例均在2～7 d(平均4.5 d)内择期行切开复位内固定.根据骨折类型分别选择不同的内固定材料.结果 17例患者术后获2个月至5年(平均1.5年)随访.采用Maryland评分标准评定疗效:优4例,良6例,可5例,差2例,优良率为58.8%.差的2例患者中1例发生创伤性关节炎,导致日常活动明显受限,二期行关节融合术;1例术后发生骨不连,行走时有疼痛感,二期行游离骨片摘除术.结论尽早选用恰当的手术方案、早期功能锻炼、较晚负重,是提高此类骨折疗效的关键.
목적 탐토족주상골체골절탈위합병투골골절적치료방법여림상료효.방법 대2005년3월지2010년3월수치적17례폐합성족주상골체골절탈위합병투골골절환자적림상자료진행회고성연구;남12례,녀5례;년령17～63세,평균40세.주골골절안조Sangeorzan분형:Ⅱ형5례,Ⅲ형12례,투골골절안조AO분형:C1형3례,C2형14례.17례균재2～7 d(평균4.5 d)내택기행절개복위내고정.근거골절류형분별선택불동적내고정재료.결과 17례환자술후획2개월지5년(평균1.5년)수방.채용Maryland평분표준평정료효:우4례,량6례,가5례,차2례,우량솔위58.8%.차적2례환자중1례발생창상성관절염,도치일상활동명현수한,이기행관절융합술;1례술후발생골불련,행주시유동통감,이기행유리골편적제술.결론 진조선용흡당적수술방안、조기공능단련、교만부중,시제고차류골절료효적관건.
Objective To explore clinical management of the navicular fracture and dislocation combined with cuboid fracture. Methods A retrospective study was done to analyze the 17 cases of closed navicular fracture and dislocation combined with cuboid fracture who had been treated from March 2005 to March 2010 in our hospital.They were 12 men and 5 women,aged from 17 to 63 years (mean,40 years).By Sangeorzan classification for navicular fractures,there were 5 cases of type Ⅱ and 12 cases of type Ⅲ; by AO classification for cuboid fractures,there were 3 cases of type C1 and 14 cases of type C2.Open reduction and internal fixation was performed for the 17 cases in 2 to 7 days (average,4.5 days).Specific fixations were used according to the specific fracture type and early functional exercises were encouraged. Results All the patients in this group were followed up from 2 months to 5 years (average,1.5 years).By the Maryland scoring system,4 cases were rated as excellent,6 cases as good,5 cases as fair and 2 cases as poor.The excellent to good rate was 58.8％.Traumatic arthritis occurred in one poor case who had to sustain secondary arthrodesis because of limitation of motion in daily activities; nonunion occurred in the other poor case who had to sustain secondary removal of free bone flaps because of pain in walking. Conclusion In treatment of navicular fracture and dislocation combined with cuboid fracture,an appropriate surgical strategy as early as possible,early functional exercise and late weight-bearing may lead to a satisfactory outcome.