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[1]杜俊鋒,陳衛(wèi)東,梁林,等.全踝關(guān)節(jié)鏡下復(fù)位經(jīng)皮內(nèi)固定治療Maisonneuve骨折[J].中醫(yī)正骨,2024,36(06):70-74.
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全踝關(guān)節(jié)鏡下復(fù)位經(jīng)皮內(nèi)固定治療Maisonneuve骨折()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期數(shù):
2024年06期
頁(yè)碼:
70-74
欄目:
臨床報(bào)道
出版日期:
2024-06-20

文章信息/Info

作者:
杜俊鋒陳衛(wèi)東梁林余春華朱仰義
紹興市上虞人民醫(yī)院,浙江 紹興 312300
關(guān)鍵詞:
踝部骨折 Maisonneuve骨折 關(guān)節(jié)鏡檢查 經(jīng)皮內(nèi)固定術(shù)
摘要:
目的:探討全踝關(guān)節(jié)鏡下復(fù)位經(jīng)皮內(nèi)固定治療Maisonneuve骨折的臨床療效和安全性。方法:2020年1月至2023年1月收治12例Maisonneuve骨折患者。男8例,女4例; 年齡21~54歲,中位數(shù)38歲; 扭傷8例,高處墜落傷2例,車禍傷2例; 所有患者均為閉合性損傷,左側(cè)5例、右側(cè)7例; Lauge-Hansen分型均為旋前外旋型Ⅳ度; 受傷至手術(shù)時(shí)間3~10 d,中位數(shù)4 d。所有患者均采用全踝關(guān)節(jié)鏡下復(fù)位經(jīng)皮內(nèi)固定治療。采用視覺模擬量表(visual analogue scale,VAS)評(píng)價(jià)踝關(guān)節(jié)疼痛程度,采用美國(guó)足與踝關(guān)節(jié)協(xié)會(huì)(American Orthopedic Foot and Ankle Society,AOFAS)踝與后足評(píng)分標(biāo)準(zhǔn)評(píng)價(jià)踝關(guān)節(jié)功能,觀察記錄治療及隨訪期間并發(fā)癥的發(fā)生情況。結(jié)果:12例患者均順利完成手術(shù),手術(shù)時(shí)間60~120 min,中位數(shù)84 min。術(shù)中未發(fā)生神經(jīng)、血管、肌腱損傷。關(guān)節(jié)鏡下檢出合并距骨軟骨損傷8例,距腓前韌帶損傷2例,踝關(guān)節(jié)游離體2例。所有患者均獲隨訪,隨訪時(shí)間12~16個(gè)月,中位數(shù)14個(gè)月。切口均甲級(jí)愈合,所有患者術(shù)后6周時(shí)均能完全負(fù)重行走,所有骨折均在3個(gè)月內(nèi)獲得骨性愈合。2例患者在康復(fù)訓(xùn)練時(shí)出現(xiàn)跟腱疼痛,經(jīng)藥物和物理治療后緩解。踝關(guān)節(jié)疼痛VAS評(píng)分,術(shù)前(6.12±1.06)分、末次隨訪時(shí)(0.33±0.20)分; 末次隨訪時(shí)AOFAS踝與后足評(píng)分(94.1±2.8)分。結(jié)論:在熟練掌握踝關(guān)節(jié)鏡技術(shù)和嚴(yán)格把握適應(yīng)證的前提下,采用全踝關(guān)節(jié)鏡下復(fù)位經(jīng)皮內(nèi)固定治療Maisonneuve骨折療效確切、安全性較高,而且具有創(chuàng)傷小、術(shù)中可發(fā)現(xiàn)和處理關(guān)節(jié)內(nèi)軟骨病變的優(yōu)勢(shì)。

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備注/Memo

備注/Memo:
基金項(xiàng)目:浙江省衛(wèi)生健康委醫(yī)藥衛(wèi)生科技計(jì)劃項(xiàng)目(2020ZH063)
通訊作者:杜俊鋒 E-mail:[email protected]
更新日期/Last Update: 1900-01-01