临床研究距骨骨折的手术治疗.PDF

2007 6 20 6 C ina J Ort op T raum a, Jun. 2007, V o.l 20, No. 6 379 吴国正 ( , 324100) ! : 探讨距骨骨折的特点类型手术方法及影响疗效的相关因素: 本组距骨骨折 39例, 其中 男 29例, 女 10例; 年 23~ 55岁, 平均 325岁骨折根据 H awkins分型方法: ∀ 型骨折 5例, #型骨折 25例, ∃型骨 折9例∀ 型骨折采用松质骨拉力螺钉内固定#∃型骨折行急诊手术, 其中# 型骨折采用前外侧切口暴露, 解剖 复位, 2枚松质骨拉力螺钉交叉内固定; ∃型骨折采用踝前内侧切口暴露, 解剖复位, 松质骨拉力螺钉内固定, 伴有内 踝骨折时同时复位内固定, 并以自体髂骨块跨骨折线嵌入植骨术后短腿石膏管形外固定 12 ~ 24周, X 线片示骨折 线模糊后拆石膏行不负重下踝关节活动, 骨折线消失后恢复伤前活动: 除 2例失访外, 37例获得随访随访时 间 15~ 6年, 平均 3年根据H awk ins疗效标准评定:优 12例( 324% ), 良 17例( 459% ), 可 6例( 162% ), 差 2例 ( 54% ), 优良率为 784% : 距骨骨折通过急诊手术解剖复位有效内固定自体髂骨块嵌入植骨局部封闭 理疗等综合治疗, 可降低病残率 ! 距骨; 骨折; 并发症; 骨折固定术 Surgery treatm ent for the fracture of talus WU Guozheng. The P eop le%sH osp ital of Jiangshan, Jiangshan 324 100, Zhe j iang, China ABSTRACT Objective: To study t e c aracteristics, classification, operative m et ods and related factors influencing t era peutic effects of fractures of t e talus. M ethods: T irtynine patien ts( 29 m ale and 10 fem ale, ranging in age from 23 to 55 years, w it an average of 325 years) w it fracture of t e talusw ere treated in t e study. Accord ing to H aw kins classification, t ere w ere 5 type ∀ , 25 type # and 9 type ∃ fractu res. Cancellous lag screw fixationw as adopted in t e treatment of patients w it type ∀ fracture, and em ergence operationw as applied to patientsw it type # and ∃ fractures. T e patientsw it type# fractures were treated w it anterior and lateral approac , anatom ic reduction and fixation w it two cancellous lag screws p laced perpend icular, and patientsw it type∃ fracturesw ere treatedw it anterior and m edial approac , anatom ic reduction and fixa tionw it two lag screw s. If t e patients were accom pan ied by t e fracture of m alleolus m edialis, t e patien tsw ere treated w it reduction and fixation at t e sam e tmi e, and mi pacted ili