CAJ | 학술논문

目的：探讨空心钉联合Herbert钉内固定治疗距骨颈骨折的手术方法及疗效。方法对23例距骨颈骨折采用踝关节前内侧、前外侧切口或双切口入路，复杂距骨骨折结合内踝截骨后用空心钉联合Herbert钉内固定治疗。结果对23例病例随访1～3年，未发生切口处皮肤坏死及感染。疗效根据美国足踝协会后足评分系统评定：优8例（34.8%），良9例（39.2%），可3例（13%），差3例（13%）。优良率74%。结论空心钉联合Herbert钉内固定治疗距骨颈骨折手术创伤小、操作简单、手术时间短、固定可靠、疗效优良、治疗费低；对复杂距骨颈骨折采用内踝截骨入路，可以大大提高距骨复位的质量，促进骨折愈合、减少后期缺血性坏死和创伤性关节炎等并发症的发生。
목적：탐토공심정연합Herbert정내고정치료거골경골절적수술방법급료효。방법대23례거골경골절채용과관절전내측、전외측절구혹쌍절구입로，복잡거골골절결합내과절골후용공심정연합Herbert정내고정치료。결과대23례병례수방1～3년，미발생절구처피부배사급감염。료효근거미국족과협회후족평분계통평정：우8례（34.8%），량9례（39.2%），가3례（13%），차3례（13%）。우량솔74%。결론공심정연합Herbert정내고정치료거골경골절수술창상소、조작간단、수술시간단、고정가고、료효우량、치료비저；대복잡거골경골절채용내과절골입로，가이대대제고거골복위적질량，촉진골절유합、감소후기결혈성배사화창상성관절염등병발증적발생。
Objective To evaluate protocal and effect of hollow compression screw combined with herbert screw in treament of talar neck fracture. Methods anteromedial or anterolateral incision or double-incision approach for ankle joint among 23 cases undergoing talar neck fracture were used, then hollow compression screw combined with herbert screw after an osteotomy of the medial malleolus for complicated talus fracture was adopted. Results There were 23 cases Followed up from1 year to 3 years, no necrosis and infection at the site of the incision skin occured. According to AOFAS Ankle Hindfoot Scale, there are 8 cases being excellent (34.8%), 9 cases being good (39.2%), 3 cases being fine (13%), 3 cases belong to bad (13%). rate of being Good is 74%. Conclusion The surgery of Hollow compression screw combined Herbert screw internal fixation for the treatment of talar neck fracture has many benefits, such as less injury, simplicity and short time operation, rigid fixation, good effect and lower cost. For medial malleolus osteotomy of the complicated talus fractures, it can greatly improve the quality of reduction of the talus and promote fracture healing and reduce the incidence of comlications of late ischemic and traumatic arthritis.