CAJ | 학술논문

背景：众所周知，踝关节骨折在临床工作中经常遇到，切开复位内固定已成为其治疗的金标准，然而踝关节骨折伴有下胫腓前韧带撕脱骨折在以往文献中鲜有报道。 　　目的：探讨Wagstaffe骨折的诊断、评估方法以及治疗措施。 　　方法：本文收集了2009年10月至2011年11月Wagstaffe骨折患者35例，均为Weber-B型踝关节骨折。男25例，女10例。按照Wagstaffe骨折分型：Ⅰ型2例，Ⅱ型27例，Ⅲ型6例。对所有患者均采用切复内固定术，术前术后进行影像学以及功能评分。 　　结果：平均随访18个月。WagstaffeⅡ型骨折在踝关节骨折中最为常见，本报道中有27例（77.1%）患者为此类骨折。AOFAS评分由术前（26.4±8.1）分提高到术后（83.1±5.9）分，Maryland足部评分由术前（37.1±7.5）分提高到术后（82.1±5.9）分，患者功能恢复良好，疼痛减轻。Leeds和Ehrlich的影像学标准优良率85.7%，无差病例。 　　结论：Wagstaffe骨折Ⅱ型发生率较高，术中对Wagstaffe骨折进行准确的复位固定可以有效提高患者术后功能恢复，降低创伤性关节炎的发生率。
배경：음소주지，과관절골절재림상공작중경상우도，절개복위내고정이성위기치료적금표준，연이과관절골절반유하경비전인대시탈골절재이왕문헌중선유보도。 　　목적：탐토Wagstaffe골절적진단、평고방법이급치료조시。 　　방법：본문수집료2009년10월지2011년11월Wagstaffe골절환자35례，균위Weber-B형과관절골절。남25례，녀10례。안조Wagstaffe골절분형：Ⅰ형2례，Ⅱ형27례，Ⅲ형6례。대소유환자균채용절복내고정술，술전술후진행영상학이급공능평분。 　　결과：평균수방18개월。WagstaffeⅡ형골절재과관절골절중최위상견，본보도중유27례（77.1%）환자위차류골절。AOFAS평분유술전（26.4±8.1）분제고도술후（83.1±5.9）분，Maryland족부평분유술전（37.1±7.5）분제고도술후（82.1±5.9）분，환자공능회복량호，동통감경。Leeds화Ehrlich적영상학표준우량솔85.7%，무차병례。 　　결론：Wagstaffe골절Ⅱ형발생솔교고，술중대Wagstaffe골절진행준학적복위고정가이유효제고환자술후공능회복，강저창상성관절염적발생솔。
Background:Ankle joint fractures are often seen in clinic, and open reduction and internal fixation had been the gold stan-dard of treatment. However, there are few of reports on ankle fractures combined with tibiofibular syndesmosis avulsion fracture in literature. Objective:The aim of the present study is to investigate the diagnosis and treatment of Wagstaffe fracture. Methods:From October 2009 to November 2011, 35 patients (25 males and 10 females) with Wagstaffe fracture underwent open reduction and internal fixation (ORIF). According to Wagstaffe classification, there were typeⅠin 2 cases, typeⅡin 27 cases, and 6 cases in typeⅢ. The American Orthopaedic Foot and Ankle Society (AOFAS) assessment and radiographic imaging were used to evaluate the clinical outcomes. Results:The mean duration of follow-up of the 35 patients was 18 months. Wagstaffe typeⅡwas the most common ankle joint fracture, and occurred in 27 (77.1%) patients in this report. AOFAS scores were 26.4±8.1 and 83.1±5.9 before and af-ter surgery. Maryland scores were 37.1±7.5 and 82.1±5.9, respectively. The good rate Leeds and Ehrlich imaging was 85.7%. Conclusions:Wagstaffe fracture type II has a high incidence rate. Accurate open reduction and internal fixation can effec-tively improve functional recovery and reduce the incidence of traumatic arthritis.