摘要
[目的]探讨由前向后空心加压螺钉内固定治疗后踝骨折块的临床疗效。[方法] 2015年6月—2020年9月,对53例患者采用由前向后空心拉力螺钉内固定踝损伤的后踝骨折块,其中男24例,女29例。评价临床及影像结果。[结果]本组患者均顺利完成手术,手术时间平均(87.23±9.50) min,术中失血量平均(105.25±21.60) ml。患者恢复完全负重活动时间为(2.08±0.78)个月。随平均随访(13.57±4.08)个月的时间推移,VAS评分显著减少(P<0.05),而AOFAS评分,以及踝背伸-跖屈ROM显著增加(P<0.05)。影像方面,术后影像显示骨折复位满意,关节面移位距离较术前明显减小(P<0.05),根据Burwell-Charnley评级,47例解剖复位,6例复位可。至末次随访时,所有患者骨折愈合,关节退变Kellgren-Lawrence评级0级45例,1级5例,2级3例。[结论]由前向后空心拉力螺钉可牢靠固定后踝骨折块,相对手术创伤小,有利于术后恢复。
[Objective] To explore the clinical outcomes of anterior-posterior placement of cannulated lag screw for internal fixation of posterior malleolus fracture fragment in ankle injuries. [Methods] From June 2015 to September 2020, a total of 53 patients, including 24males and 29 females, received anterior-posterior placement of cannulated lag screw for internal fixation of posterior malleolus fracture fragment complicated in ankle injuries in our hospital. The clinical and imaging results were evaluated. [Results] All the patients had operation performed smoothly with operation time of(87.23±9.50) min, and intraoperative blood loss of(105.25±21.60) ml, and then resumed full weight-bearing activity in(2.08±0.78) months on an average postoperatively. As time went during the follow up lasted for a mean of(13.57±4.08) months, the VAS scores significantly decreased(P<0.05), while AOFAS scores and ankle dorsal extension-plantar flexion range of motion(ROM) significantly increased(P<0.05). Radiographically, postoperative images showed satisfactory fracture reduction achieved in all the patients, with significantly declined displacement distance of articular surface compared with that before surgery(P<0.05). According to Burwell-Charnley criteria, 47 patients were marked as anatomic fracture reduction, while the remaining 6 patients as acceptable reduction. By the time of last follow-up, all patients got fracture union with the joint degeneration of grade 0 in 45 cases, grade 1 in 5 cases,and grade 2 in 3 cases in term of Kellgren-Lawrence classification. [Conclusion] This anterior and posterior placement of cannulated screws does firmly fix the posterior malleolus fracture fragment in ankle injuries, which minimizes the iatrogenic trauma and is beneficial to postoperative recovery.
作者
高懋峰
王治栋
朱若夫
施卫东
干旻峰
GAO Mao-feng;WANG Zhi-dong;ZHU Ruo-fu;SHI Wei-dong;GAN Min-feng(Department of Orthopedics,The First Affiliated Hospital,Soochow University,Suzhou 215006,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2022年第24期2281-2284,共4页
Orthopedic Journal of China
关键词
足踝
后踝骨折
空心钉
内固定
ankle
posterior malleolus fracture
cannulated screw
internal fixation
