老年踝关节骨折的手术治疗
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作者Author单位AddressE-Mail
朱渊 ZHU Yuan 上海交通大学附属瑞金医院骨科 上海市伤骨科研究所,上海 200025 Department of Orthopaedics, Ruijin Hospital, Shanghai Jiaotong University, Shanghai Orthopaedic Institute, Shanghai 200025, China xu664531@hotmail.com 
徐向阳 XU Xiang-yang 上海交通大学附属瑞金医院骨科 上海市伤骨科研究所,上海 200025 Department of Orthopaedics, Ruijin Hospital, Shanghai Jiaotong University, Shanghai Orthopaedic Institute, Shanghai 200025, China  
刘津浩 LIU Jin-hao 上海交通大学附属瑞金医院骨科 上海市伤骨科研究所,上海 200025 Department of Orthopaedics, Ruijin Hospital, Shanghai Jiaotong University, Shanghai Orthopaedic Institute, Shanghai 200025, China  
期刊信息:《中国骨伤》2010年,第23卷,第11期,第828-831页
DOI:10.3969/j.issn.1003-0034.2010.11.010
基金项目:
中文摘要:

目的:分析总结老年人踝关节骨折手术治疗的效果、以及增加手术成功率的手术技巧。

方法:回顾性分析2003年1月至2008年12月老年踝关节骨折手术治疗病例128例,男26例,女102例;年龄50~82岁,平均69岁。根据Lange-Hanson分型:旋后外旋型113例,旋前外旋型8例,旋后内收型5例,旋前外展型2例。所有患者施行切开复位内固定术,记录手术方法、早期并发症、患者满意度,应用美国足踝外科协会(AOFAS)踝与后足评分评定手术效果。

结果:128例术后获得随访,时间6个月~6年,平均36个月。伤口延迟愈合11例(8.6%);无深部感染、骨折不愈合、内固定翻修等情况发生。AOFAS评分疼痛评分(33.5±5.6)分,功能评分(40.2±7.4)分,后足的排列均得到10分,总分(83.6±6.3)分。

结论:手术治疗骨质疏松性老年人踝关节骨折应是多数情况下的首选方法。虽然骨质疏松使内固定手术的难度增加,但是通过手术方法的改进,能够使老年踝关节骨折取得好的治疗效果。
【关键词】踝关节  骨折  骨折固定术,内  老年人
 
Surgical treatment of ankle fracture in the elderly
ABSTRACT  

Objective: To analysis the outcomes and the technique of surgical operation of osteoporotic ankle fracture in the elderly.

Methods: One hundred and twenty-eight patients with osteoporotic ankle fracture were treated by surgical operation from January 2003 to December 2008,included 26 males and 102 females, with an average age of 69 years old ranging from 50 to 82 years. According to Lange-Hanson classification, there were 113 cases of supinatio-extorsion,18 of pronate-extorsion,5 of supinatio-adduction,2 of pronate-abduction. The methods of fixation,the complications,and the AOFAS scores after operation were recorded.

Results: All the 128 patients were followed up from 6 months to 6 years (averaged in 36 months). Delayed wound healing occurred in 11 cases(8.6%). There was no deep infection,nonunion of the fracture,and revision. The average AOFAS scores after operation was 83.6±6.3 (the mean pain scores were 33.5±5.6,the mean function scores were 40.2±7.4,the mean alignment scores were 10).

Conclusion: Surgical treatment should be the first choice in osteoporotic ankle fracture in most cases. Improved procedures can make the results better.
KEY WORDS  Ankle joint  Fractures  Fracture fixation,internal  Aged
 
引用本文,请按以下格式著录参考文献:
中文格式:朱渊,徐向阳,刘津浩.老年踝关节骨折的手术治疗[J].中国骨伤,2010,23(11):828~831
英文格式:ZHU Yuan,XU Xiang-yang,LIU Jin-hao.Surgical treatment of ankle fracture in the elderly[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(11):828~831
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