摘要
[目的]探讨后外联合后内侧入路开放复位内固定后踝骨折的临床疗效。[方法]2017年7月—2020年6月,本科采用后外联合后内侧入路开放复位内固定29例HaraguchiⅡ型后踝骨折患者的临床资料。评价临床与影像资料。[结果]所有患者均顺利完成手术,手术时间72~123 min,平均(85.2±18.7)min,术中出血量30~80 ml,平均(47.4±23.8)ml,手术切口均愈合良好。所有病例均获随访15~34个月,平均(20.1±3.5)个月。随术后时间延长,AOFAS评分、VAS评分和踝关节活动度均逐渐改善(P<0.05)。影像显示骨折复位质量,优24例,良5例,优良率为100.0%。骨折愈合时间11~15周。末次随访时,3例踝关节退变评级为1级,术后各时间点差异无统计学意义(P>0.05),无骨折移位、骨折不愈合及内固定松动。[结论]后外联合后内侧入路治疗后踝骨折,骨折端显露充分,利于骨折复位及固定,关节功能恢复良好。
[Objective]To evaluate the clinical efficiency of the posterolateral combined with the posteromedial approaches for open re⁃duction and internal fixation(ORIF)of posterior malleolus fractures.[Methods]From July 2017 to June 2020,29 patients received ORIF of Haraguchi typeⅡposterior malleolus fractures through the posterolateral combined with the posteromedial approaches in our department.Clinical and imaging documents of the patients were evaluated.[Results]All the patients had the operation performed smoothly,with opera⁃tion time of 72~123 min with a mean of(85.2±18.7)min and the intraoperative blood loss of 30~80 ml with a mean of(47.4±23.8)ml,and good incision healing.All of them were followed up for 15 to 34 months,with an average of(20.1±3.5)months.The AOFAS score,VAS score and ankle range of motion significantly improved over time postoperatively(P<0.05).Radiographically,the quality of fracture reduc⁃tion was excellent in 24 cases,good in 5 cases and poor in 0 case,with an excellent and good rate of 100.0%.All the patients got fracture healed in 11~15 weeks postoperatively,with grade 1 ankle degeneration in 3 patients,which was not significantly different among each time points after operation(P>0.05),however,no fracture displacement,fracture nonunion and internal fixation loosening were noted in anyone of them until the latest follow-up.[Conclusion]The posterolateral combined with posteromedial approaches is fully exposed posterior mal⁃leolus fractures,which is conducive to fracture reduction and fixation with satisfactory function recovery.
作者
陈伟
郑金鑫
侯晓斌
冯凤辉
CHEN Wei;ZHENG Jin-xin;HOU Xiao-bin;FENG Feng-hui(Department of Orthopedics,The Third Central Hospital of Tianjin City,Tianjin 300170,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2023年第4期369-372,共4页
Orthopedic Journal of China
关键词
后踝骨折
开放复位内固定
后外侧入路
后内侧入路
posterior malleolus fracture
open reduction and internal fixation
posterolateral approach
posteromedial approach
