摘要
目的:探讨后踝骨折治疗的手术入路,满足关节早期功能锻炼,指导临床实践。方法:2012年5月-2015年10月我院收治的合并后踝II型骨折的踝关节骨折30例,按回顾性方法分析,其中30例患者后踝骨折均进行钢板螺钉内固定,手术选择后内侧入路,男性20例,女性10例,年龄28-57岁,平均年龄34岁,其中车祸伤13例,扭伤17例,全部为闭合骨折,按照Lauge-Hansen分型,全部为旋后外旋型Ⅳ度,后踝骨折全部为Ⅱ型(内侧延伸型)。结果:骨折术后2天复查X线进行Burwell-Charnley评价,30例患者均得到完整的随访,随访时间5-14个月,平均随访时间9个月,所有患者均骨性愈合,进行AOFAS(.美国足与踝关节协会)功能评分量表进行评分,优27例,良2例,一般1例,差0例。结论:对于合并Ⅱ型后踝骨折的踝关节骨折,采用后内侧入路能更加直接显露骨折,选择合理的内固定材料进行坚强固定,满足踝关节功能锻炼,减少术后创伤性关节炎等并发症的发生。
Objective:To investigate the treatment oi ankle fractures surgical approach to meet the joint early functional exercise,to guide clinical practice.Methods:25 May 2012 Month-October 2015 after the merger in our hospital ankle type II fractures ankle fractures,30 cases analyzed by retrospective method,in which 30 patients with ankle fractures underwent plate fixation screws,surgical options medial posterior approach,20 males and 10 females,aged 28-57 years,mean age 34 years,oi which traffic accident in 13 cases,17 cases of sprains,all closed fractures,according to the Lauge-Hansen classification,all for a spin external rotation type Ⅳ degree,after all ankle fracture type Ⅱ(medial malleolus extended).Results:After 2 days of review X-ray and Burwell-Charnley evaluation,30 patients have received a complete follow-up for 5-14 months with an average follow-up time of 10 months,all patients were healed,were AOFAS(American foot and ankle Society) function rating scale score,excellent in 27 cases,good in 2 cases,1 case,0 poor.Conclusion:For the combined type Ⅱ ankle fracture ankle fracture,medial approach can be adopted more direct exposure of the fracture,a reasonable choice of internal fixation material strong fixation,meet ankle "Junctional exercise,reduce postoperative complications such as traumatic arthritis happened.
引文
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