中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2014年
7期
133-134
,共2页
距骨骨折%手术治疗%临床疗效
距骨骨摺%手術治療%臨床療效
거골골절%수술치료%림상료효
Talus fracture%Operative treatment%Clinical efficacy
目的：探讨距骨骨折经手术治疗后的的临床疗效。方法：手术治疗距骨骨折16例，骨折分型依据Hawkins分型，Ⅰ型2例，Ⅱ型5例，Ⅲ型6例，Ⅳ型3例。Ⅰ型距骨骨折采用透视下闭合复位松质骨拉力螺钉内固定，Ⅱ、Ⅲ、Ⅳ型骨折行切开复位2枚松质骨拉力螺钉交叉内固定治疗，切口采用前外侧或前内侧切口暴露。术后踝关节中立位短腿石膏管形外固定8~12周，拆除石膏行不负重下踝关节活动，X线片示有连续骨痂通过骨折线可负重行日常活动。结果：所有患者术后均获得随访，随访时间6~48个月，平均30.3个月。术后功能评分使用美国足踝协会后足评分系统(AOFAS)评定，优5例，良8例，可2例，差1例，优良率为81.3%。结论：及时早期手术、合理手术方案、骨折解剖复位、距骨血运的保护、坚强有效的内固定、合理植骨、早期踝关节功能锻炼可提高距骨骨折手术后的临床疗效，减少骨折后并发症的发生。
目的：探討距骨骨摺經手術治療後的的臨床療效。方法：手術治療距骨骨摺16例，骨摺分型依據Hawkins分型，Ⅰ型2例，Ⅱ型5例，Ⅲ型6例，Ⅳ型3例。Ⅰ型距骨骨摺採用透視下閉閤複位鬆質骨拉力螺釘內固定，Ⅱ、Ⅲ、Ⅳ型骨摺行切開複位2枚鬆質骨拉力螺釘交扠內固定治療，切口採用前外側或前內側切口暴露。術後踝關節中立位短腿石膏管形外固定8~12週，拆除石膏行不負重下踝關節活動，X線片示有連續骨痂通過骨摺線可負重行日常活動。結果：所有患者術後均穫得隨訪，隨訪時間6~48箇月，平均30.3箇月。術後功能評分使用美國足踝協會後足評分繫統(AOFAS)評定，優5例，良8例，可2例，差1例，優良率為81.3%。結論：及時早期手術、閤理手術方案、骨摺解剖複位、距骨血運的保護、堅彊有效的內固定、閤理植骨、早期踝關節功能鍛煉可提高距骨骨摺手術後的臨床療效，減少骨摺後併髮癥的髮生。
목적：탐토거골골절경수술치료후적적림상료효。방법：수술치료거골골절16례，골절분형의거Hawkins분형，Ⅰ형2례，Ⅱ형5례，Ⅲ형6례，Ⅳ형3례。Ⅰ형거골골절채용투시하폐합복위송질골랍력라정내고정，Ⅱ、Ⅲ、Ⅳ형골절행절개복위2매송질골랍력라정교차내고정치료，절구채용전외측혹전내측절구폭로。술후과관절중립위단퇴석고관형외고정8~12주，탁제석고행불부중하과관절활동，X선편시유련속골가통과골절선가부중행일상활동。결과：소유환자술후균획득수방，수방시간6~48개월，평균30.3개월。술후공능평분사용미국족과협회후족평분계통(AOFAS)평정，우5례，량8례，가2례，차1례，우량솔위81.3%。결론：급시조기수술、합리수술방안、골절해부복위、거골혈운적보호、견강유효적내고정、합리식골、조기과관절공능단련가제고거골골절수술후적림상료효，감소골절후병발증적발생。
Objective:To explore the clinical efficacy of talus fracture by operative treatment.Method:16 cases of talus fracture with operative treatment, according to Hawkins fracture type classification,Ⅰtype 2 cases,Ⅱtype 5 cases,Ⅲtype 6 cases,Ⅳtype 3 cases.Ⅰtype talus fractures closed reduction and screw fixation under fluoroscopy cancellous lag.TypeⅡ,Ⅲ,Ⅳtype fracture underwent open reduction and two cancellous lag screw fixation cross incision using anterolateral or anteromedial incision.Ankle in neutral position short leg cast tubular external fixator 8-12 weeks postoperative,did not remove the plaster line under load ankle,daily activities were taken after X-ray showed a continuous fracture callus lines.All patients were followed up for 6-48 months,average 30.3 months.Result:All patients were followed up for 6-48 months,average 30.1 months.Acording to AOFAS hindfoot scoring system criteria,there were excellent in 5 cases,good in 8 cases,fair in 2 cases,poor in 1 case,with the good rate of 81.3%.Conclusion:Timely early surgery,reasonable surgical plan,anatomical reduction,protection of the talus blood,strong and effective internal fixation,bone graft reasonable,early functional exercise can improve the clinical efficacy after operatian and reduce complications after fracture happen.
