中国中西医结合外科杂志
中國中西醫結閤外科雜誌
중국중서의결합외과잡지
CHINESE JOURNAL OF SURGERY OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE
2014年
6期
596-599
,共4页
后踝骨折%后外侧入路%内固定
後踝骨摺%後外側入路%內固定
후과골절%후외측입로%내고정
Posterior malleolar fracture%posterolateral approach%internal fixation
目的：探讨后外侧入路治疗后踝关节骨折的临床疗效及并发症。方法：采用后外侧入路治疗后踝骨折患者34例，采用Lauge-Hansen分型，旋后-外旋型26例；旋前-外旋型损伤8例。CT检查显示27例后踝骨折块占胫骨远端关节面积大于25%，7例大于10%，骨折移位程度均大于2 mm。术后采用Baird-Jackson踝关节功能评定标准对患者踝关节功能进行评价。结果：34例患者均获得随访，平均随访12.5个月。术后2周伤口一期愈合。复查X线检查，骨折对位满意，后踝骨折均获得骨性愈合。4例患者出现腓肠神经支配区麻木，2例患者术后半年完全恢复，1例有所好转，1例无明显改善。3例患者踝部疼痛明显，取出外踝钢板后症状消失。Baird-Jackson踝关节评分优20例，良9例，可4例，差1例，优良率85.3%。结论：后外侧入路治疗后踝骨折便于骨折复位且固定牢靠，可同时处理腓骨骨折。
目的：探討後外側入路治療後踝關節骨摺的臨床療效及併髮癥。方法：採用後外側入路治療後踝骨摺患者34例，採用Lauge-Hansen分型，鏇後-外鏇型26例；鏇前-外鏇型損傷8例。CT檢查顯示27例後踝骨摺塊佔脛骨遠耑關節麵積大于25%，7例大于10%，骨摺移位程度均大于2 mm。術後採用Baird-Jackson踝關節功能評定標準對患者踝關節功能進行評價。結果：34例患者均穫得隨訪，平均隨訪12.5箇月。術後2週傷口一期愈閤。複查X線檢查，骨摺對位滿意，後踝骨摺均穫得骨性愈閤。4例患者齣現腓腸神經支配區痳木，2例患者術後半年完全恢複，1例有所好轉，1例無明顯改善。3例患者踝部疼痛明顯，取齣外踝鋼闆後癥狀消失。Baird-Jackson踝關節評分優20例，良9例，可4例，差1例，優良率85.3%。結論：後外側入路治療後踝骨摺便于骨摺複位且固定牢靠，可同時處理腓骨骨摺。
목적：탐토후외측입로치료후과관절골절적림상료효급병발증。방법：채용후외측입로치료후과골절환자34례，채용Lauge-Hansen분형，선후-외선형26례；선전-외선형손상8례。CT검사현시27례후과골절괴점경골원단관절면적대우25%，7례대우10%，골절이위정도균대우2 mm。술후채용Baird-Jackson과관절공능평정표준대환자과관절공능진행평개。결과：34례환자균획득수방，평균수방12.5개월。술후2주상구일기유합。복사X선검사，골절대위만의，후과골절균획득골성유합。4례환자출현비장신경지배구마목，2례환자술후반년완전회복，1례유소호전，1례무명현개선。3례환자과부동통명현，취출외과강판후증상소실。Baird-Jackson과관절평분우20례，량9례，가4례，차1례，우량솔85.3%。결론：후외측입로치료후과골절편우골절복위차고정뢰고，가동시처리비골골절。
Objective To analyze the clinical effects and complications of treatment of posterior malleolar fracture with posterolateral approach. Methods Posterior malleolar fractures were treated through the postero?lateral approach in 34 patients. Medial malleolar fracture was found in 23, medial deltoid ligament rupture in 4, lateral malleolar fracture in all patients.According to Lauge-Hansen system,supination external rotation was found in 26, pronation external rotation in 8.CT scan showed that the size of fragment exceeded 25%of the artic?ular surface in 27,and in 7cases exceeded 10%.All displacements were more than 2mm.The ankle function was evaluated by Baird-Jackson criteria. Results All patients were followed up for average 12.5 months.The wounds healed in all patients postoperatively 2 weeks. X-Ray showed all cases healed with accurate reduction. Four patients had numbness in the sural distribution.Two patients had complete resolution following surgery six months,one patient had improvement,one patient had still symptoms.According to the Baird-Jackson criteria,the results were rated as excellent in 20, good in 9,moderate in 4, and poor in 1, with the good-excellent rate being 85.3%. Conclusion The posterolateral approach is the optimal method that provides excellent visualization,fa?cilitates more accurate reduction and rigid fixation.
