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[1]李春陽,趙洪濤.腓骨入路切開復(fù)位內(nèi)固定治療旋后外旋型踝關(guān)節(jié)骨折[J].中醫(yī)正骨,2019,31(05):59-61.
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腓骨入路切開復(fù)位內(nèi)固定治療旋后外旋型踝關(guān)節(jié)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:
59-61
欄目:
臨床報(bào)道
出版日期:
2019-05-20

文章信息/Info

作者:
李春陽; 趙洪濤
(三門峽市中醫(yī)院,河南 三門峽 472000)
關(guān)鍵詞:
踝關(guān)節(jié);  踝損傷;  骨折固定術(shù); 內(nèi);  旋后外旋型
摘要:
目的:觀察腓骨入路切開復(fù)位內(nèi)固定治療旋后外旋型踝關(guān)節(jié)骨折的臨床療效及安全性。方法:2014年3月至2017年3月,采用腓骨入路切開復(fù)位內(nèi)固定治療旋后外旋型踝關(guān)節(jié)骨折患者60例。男32例,女28例。年齡21～68歲,中位數(shù)47歲。左側(cè)31例,右側(cè)29例。閉合性損傷48例,開放性損傷12例。按照踝關(guān)節(jié)骨折的Lauge-Hansen分型標(biāo)準(zhǔn),均為旋后外旋型,其中Ⅲ度26例、Ⅳ度34例。受傷至手術(shù)時(shí)間1～13 d,中位數(shù)7.5 d。術(shù)后隨訪觀察骨折愈合、踝關(guān)節(jié)功能恢復(fù)及并發(fā)癥發(fā)生情況。結(jié)果:60例患者中2例失訪,其余58例均獲隨訪,隨訪時(shí)間12～18個(gè)月,中位數(shù)14個(gè)月。1例切口愈合不良,由切口周圍皮膚張力過高所致,局部常規(guī)消毒、更換敷料,3周后切口愈合; 1例出現(xiàn)下肢肌間靜脈血栓,抗凝治療后血栓消失; 1例關(guān)節(jié)面復(fù)位不良,可能是骨質(zhì)疏松造成復(fù)位丟失,因未出現(xiàn)臨床癥狀而未進(jìn)行治療。骨折均愈合,愈合時(shí)間8～12周,中位數(shù)8周。術(shù)后12個(gè)月,美國足與踝關(guān)節(jié)協(xié)會(huì)(American Orthopedic Foot and Ankle Society,AOFAS)踝與后足功能評分(92.4±6.1)分,優(yōu)54例、良3例、差1例。差的1例,早期未進(jìn)行功能鍛煉而導(dǎo)致踝關(guān)節(jié)僵硬,進(jìn)行主動(dòng)及被動(dòng)功能鍛煉后關(guān)節(jié)僵硬癥狀消失,AOFAS踝與后足功能評定結(jié)果為良。結(jié)論:腓骨入路切開復(fù)位內(nèi)固定治療旋后外旋型踝關(guān)節(jié)骨折,骨折愈合率高,踝關(guān)節(jié)功能恢復(fù)好,安全性較高,值得臨床推廣應(yīng)用。

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更新日期/Last Update: 2019-05-20