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[1]蘇攀,趙鵬,穆世民,等.Gatellier-Chastang后外側(cè)入路治療合并Die-punch骨塊的后踝骨折[J].中醫(yī)正骨,2019,31(05):55-58.
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Gatellier-Chastang后外側(cè)入路治療合并Die-punch骨塊的后踝骨折()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年05期
頁碼:
55-58
欄目:
臨床報道
出版日期:
2019-05-20

文章信息/Info

作者:
蘇攀; 趙鵬; 穆世民; 婁磊
(河南省洛陽正骨醫(yī)院/河南省骨科醫(yī)院,河南 洛陽 471002)
關鍵詞:
踝關節(jié);  關節(jié)內(nèi)骨折;  骨折固定術
摘要:
目的:探討Gatellier-Chastang后外側(cè)入路治療合并Die-punch骨塊的后踝骨折的臨床療效。方法:2016年3月至2018年2月,采用Gatellier-Chastang后外側(cè)入路治療合并Die-punch骨塊的后踝骨折患者23例,男9例、女14例; 年齡24～71歲,中位數(shù)50歲。合并外踝骨折4例,合并外踝骨折、下脛腓聯(lián)合損傷2例,合并內(nèi)、外踝骨折及踝關節(jié)半脫位10例,合并內(nèi)、外踝骨折及踝關節(jié)半脫位、下脛腓聯(lián)合損傷4例,合并外踝骨折、三角韌帶損傷、踝關節(jié)半脫位2例,合并外踝骨折、三角韌帶損傷、踝關節(jié)半脫位、下脛腓聯(lián)合損傷1例。受傷至手術時間5～22 d,中位數(shù)9 d。術中先復位Die-punch骨塊,對合關節(jié)面平整后再復位固定后踝骨折。術后1周,在X線片上采用Burwell-Charnley影像學評估標準(1965)對骨折復位情況進行評價。觀察骨折愈合情況,采用美國足踝外科協(xié)會(American Orthopaedic Foot and Ankle Society,AOFAS)踝與后足功能評分標準評價踝關節(jié)功能。結(jié)果:本組23例均順利完成手術。術后1周依據(jù)上述評價標準,本組解剖復位19例、復位可3例、復位差1例。骨折復位可的3例,關節(jié)面挫傷、軟骨剝脫,關節(jié)面骨質(zhì)有缺損; 骨折復位差的1例,關節(jié)面出現(xiàn)約0.5 cm的臺階。患者均獲隨訪,隨訪時間12～19個月,中位數(shù)16個月。骨折均愈合,愈合時間9～22周,中位數(shù)14周。末次隨訪時,本組踝關節(jié)AOFAS評分(82.70±14.76)分,優(yōu)15例、良5例、可3例。結(jié)論:Gatellier-Chastang后外側(cè)入路治療合并Die-punch骨塊的后踝骨折,骨折復位、愈合好,有利于踝關節(jié)功能恢復。

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更新日期/Last Update: 2019-05-20