中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2015年
3期
232-237
,共6页
龚晓峰%武勇%吕艳伟%王岩%王金辉%王满宜
龔曉峰%武勇%呂豔偉%王巖%王金輝%王滿宜
공효봉%무용%려염위%왕암%왕금휘%왕만의
踝关节%骨折%骨折固定术,内%适应证
踝關節%骨摺%骨摺固定術,內%適應證
과관절%골절%골절고정술,내%괄응증
Ankle joint%Fractures,bone%Fracture fixation,internal%Indication
目的 探讨后踝骨折手术治疗的指征. 方法 回顾性分析2011年1月1日至12月31日收治的298例合并后踝骨折的踝关节骨折的临床资料,男143例,女155例;年龄14 ～ 85岁,平均43岁;右侧152例,左侧146例.分别分析胫距关节脱位、踝关节骨折Danis-Weber分型、后踝骨折Haraguchi分型、后踝骨折块面积和后踝骨折手术固定与否的关系. 结果 胫距关节脱位后踝骨折的固定比率(57.0％)高于不脱位时(34.0％),HaraguchiⅡ型后踝骨折的固定比率(73.8％)高于Haraguchi Ⅰ型(35.5％)和Ⅲ型(0)骨折,当后踝骨块面积超过15％时固定比率明显增大,差异有统计学意义(P＜0.05);踝关节骨折Danis-Weber分型与后踝骨折固定无显著相关(P＞0.05). 结论 影响选择手术固定后踝的因素包括原始损伤合并胫距关节脱位、HaraguchiⅡ型骨折的后踝骨折、后踝骨折块面积超过15％.
目的 探討後踝骨摺手術治療的指徵. 方法 迴顧性分析2011年1月1日至12月31日收治的298例閤併後踝骨摺的踝關節骨摺的臨床資料,男143例,女155例;年齡14 ～ 85歲,平均43歲;右側152例,左側146例.分彆分析脛距關節脫位、踝關節骨摺Danis-Weber分型、後踝骨摺Haraguchi分型、後踝骨摺塊麵積和後踝骨摺手術固定與否的關繫. 結果 脛距關節脫位後踝骨摺的固定比率(57.0％)高于不脫位時(34.0％),HaraguchiⅡ型後踝骨摺的固定比率(73.8％)高于Haraguchi Ⅰ型(35.5％)和Ⅲ型(0)骨摺,噹後踝骨塊麵積超過15％時固定比率明顯增大,差異有統計學意義(P＜0.05);踝關節骨摺Danis-Weber分型與後踝骨摺固定無顯著相關(P＞0.05). 結論 影響選擇手術固定後踝的因素包括原始損傷閤併脛距關節脫位、HaraguchiⅡ型骨摺的後踝骨摺、後踝骨摺塊麵積超過15％.
목적 탐토후과골절수술치료적지정. 방법 회고성분석2011년1월1일지12월31일수치적298례합병후과골절적과관절골절적림상자료,남143례,녀155례;년령14 ～ 85세,평균43세;우측152례,좌측146례.분별분석경거관절탈위、과관절골절Danis-Weber분형、후과골절Haraguchi분형、후과골절괴면적화후과골절수술고정여부적관계. 결과 경거관절탈위후과골절적고정비솔(57.0％)고우불탈위시(34.0％),HaraguchiⅡ형후과골절적고정비솔(73.8％)고우Haraguchi Ⅰ형(35.5％)화Ⅲ형(0)골절,당후과골괴면적초과15％시고정비솔명현증대,차이유통계학의의(P＜0.05);과관절골절Danis-Weber분형여후과골절고정무현저상관(P＞0.05). 결론 영향선택수술고정후과적인소포괄원시손상합병경거관절탈위、HaraguchiⅡ형골절적후과골절、후과골절괴면적초과15％.
Objective To explore the operative indications for posterior malleolar fractures.Methods A retrospective study was conducted to analyze the clinical data of the whole year of 2011 of 298 combined fractures of ankle joint and posterior malleolus.They were 143 males and 155 females,14 to 85 years of age(average,43 years).Laterality:152 right sides and 146 left sides.Associations of surgical fixation were analyzed respectively with dislocation of the tibiotalar joint,Danis-Weber classification of the ankle fracture,Haraguchi classification of posterior malleolar fracture,and fragmental size of posterior malleolar fracture.Results Significantly more posterior malleolar fractures combined with dislocation of the tibiotalar joint (57.0％) were subjected to surgical fixation than those without (34.0％) (P ＜ 0.05).Significantly nore Haraguchi type Ⅱ fractures (73.8％) were subjected to surgical fixation than those of Haraguchi type Ⅰ (35.5％) and type Ⅲ[(P ＜ 0.05).The fixation ratio increased significantly when the posterior fragment was more than 15％ of the total joint area (P ＜ 0.05).There was no significant association between the Danis-Weber classification and surgical fixation (P ＞ 0.05).Conclusion In clinical treatment of posterior malleolar fractures,the factors influencing operative decision include combined dislocation of the tibiotalar joint,Haraguchi type Ⅱ,and fragmental size more than 15％ of the total joint area.
