摘要
目的:探讨后内侧联合后外侧入路治疗外踝、后踝HaraguchiⅡ、Ⅲ型骨折的临床疗效。方法:对2017年1月至2021年1月52例伴有外踝、后踝HaraguchiⅡ、Ⅲ型的踝关节骨折患者,通过俯卧位后内侧联合后外侧入路进行复位外踝钢板固定、后踝微型钢板或中空螺钉固定。其中男37例,女15例,平均年龄为(38.3±14.9)岁。收集患者手术时间、出血量、骨折愈合时间及并发症发生情况,并根据Baird-Jackson踝关节功能评分评估疗效。结果:本组患者平均手术时间为(105.7±28.4)min,平均出血量为(68.4±18.7)mL。关节面复位台阶均小于2 mm,所有患者均获得随访,时间为14~23个月,平均为(16.4±4.7)个月,骨折愈合时间为(3.2±1.7)个月,末次随访时Baird-Jackson踝关节功能平均评分为(93.5±3.7)分。其中优44例,良8例,优良率为100%。本组患者均未出现皮肤坏死、切口感染及内固定失败等并发症。结论:后内侧联合后外侧入路治疗外踝、后踝HaraguchiⅡ、Ⅲ型骨折疗效满意,直视下同时显露、复位与固定后踝骨块,并发症少。
Objective:To investigate the clinical efficacy of posteromedial combined with posterolateral approach on the treatment of lateral and posterior malleolus fracture of Haraguchi typeⅡandⅢ.Methods:From January 2017 to January 2021,52 patients of ankle fractures with lateral malleolus and posterior Haraguchi typeⅡandⅢwere treated by reduction and fixation with lateral malleolus plate,posterior malleolus mini-plate or hollow screw through posteromedial combined posterolateral approach in prone position.There were 37 males and 15 females,with an average age of(38.3±14.9)years old.And the operative time,intraoperative bleeding,fracture healing time and complications were recorded.Clinical efficacy was evaluated according to Baird-Jackson ankle function score.Results:The average operation time was(105.7±28.4)min,and the average blood loss was(68.4±18.7)mL.The articular surface reduction steps were less than 2 mm.All patients were followed up for 14 to 23(16.4±4.7)months.Fracture healing time was(3.2±1.7)months,and the average score of Baird-Jackson ankle function was(93.5±3.7)points at the last follow-up,of which 44 cases were excellent and 8 cases were good,with an excellent rate of 100%.There were no complications such as skin necrosis,incision infection,and internal fixation failure in this group.Conclusion:The posteromedial combined with posterolateral approach has satisfactory efficacy on the treatment of lateral malleolus and posterior ankle Haraguchi typeⅡandⅢfractures,and the posterior ankle bone is simultaneously exposed,reduced and fixed under direct vision,with few complications.
作者
何永志
陈志达
张哲明
蔡弢艺
张剑平
HE Yongzhi;CHEN Zhida;ZHANG Zheming;CAI Taoyi;ZHANG Jianping(Orthopaedic Center of People's Liberation Army,The 909th Hospital of Joint Logistic Support Force(Dongnan Hospital of Xiamen University),Zhangzhou 363000,Fujian China)
出处
《中国中医骨伤科杂志》
CAS
2023年第6期66-70,共5页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
漳州市自然科学基金项目(ZZ2018J10)
全军军事训练伤防治研究专项(21XLS23)。
关键词
踝关节骨折
后踝
外踝
微型钢板
ankle joint fracture
posterior malleolus
external malleolus
mini-plate
