| 皮质螺钉治疗下胫腓联合分离伴踝关节骨折 |
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投稿时间：2014-06-09
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| 作者 | Author | 单位 | Address | E-Mail |
| 余斌峰 |
YU Bin-feng |
温州医科大学附属第三医院创伤骨科, 浙江 温州 325200 |
Department of Orthopaedics, the Third Hospital Affiliated to Wenzhou Medical College, Wenzhou 325200, Zhejiang, China |
695326161@qq.com |
| 王伟良 |
WANG Wei-liang |
温州医科大学附属第三医院创伤骨科, 浙江 温州 325200 |
Department of Orthopaedics, the Third Hospital Affiliated to Wenzhou Medical College, Wenzhou 325200, Zhejiang, China |
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| 林锡鹏 |
LIN Xi-peng |
温州医科大学附属第三医院创伤骨科, 浙江 温州 325200 |
Department of Orthopaedics, the Third Hospital Affiliated to Wenzhou Medical College, Wenzhou 325200, Zhejiang, China |
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| 期刊信息：《中国骨伤》2015年，第28卷，第7期，第663-665页 |
| DOI：10.3969/j.issn.1003-0034.2015.07.019 |
| 基金项目:瑞安市科技计划项目(编号:20120375) |
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中文摘要:
目的:探讨皮质螺钉治疗下胫腓分离伴踝关节骨折的临床经验。
方法:收集2008年3月至2012年5月采用皮质螺钉治疗下胫腓联合分离44例,左侧20例,右侧24例;均为闭合性损伤。按Lauge-Hansen分型:旋后外旋型18例,其中Ⅱ型4例,Ⅲ型8例,Ⅳ型6例;旋前外旋型14例,其中Ⅲ型6例,Ⅳ型8例;旋前外展型12例,其中Ⅱ型4例,Ⅲ型8例。按3踝损伤情况,其中1踝4例,2踝28例,3踝12例。术前所有患者根据病史、查体及影像学检查明确诊断,术后采用Baird-Jackson评分标准及踝关节活动度进行临床疗效评价。
结果:所有患者获得随访,时间11～23个月,平均15.7个月。术后未见创口感染、骨不愈合、下胫腓联合再次分离等并发症发生。术后Baird-Jackson评分91.56±6.26(75～99分),其中优26例,良10例,可6例,差2例。术后出现1例断钉,取出断钉后未进行外固定,功能良好。1例1度骨性关节炎,采用理疗及关节腔注射治疗后好转。
结论:皮质螺钉是治疗下胫腓联合分离的有效手段,明确的诊断、良好的手术操作、术后合理的功能锻炼、及时随访复查是影响其预后的重要因素。 |
| 【关键词】踝关节 创作和损伤 骨折固定术 |
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| Treatment of tibiofibular syndesmosis together with ankle fracture using cortical screw |
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ABSTRACT
Objective: To investigate the clinical experiment of cortical screw in the treatment of tibiofibular syndesmosis separation together with ankle fractures.
Methods: From March 2008 to May 2012,42 patients with tibiofibular syndesmosis separation were treated with cortical screw,including 20 cases in the left and 24 cases in the right. All the patients had closed injury. According to Lauge-Hansen classification,there were 18 cases of supination-external rotation,in which 4 patients with injuries belong to typeⅡ,8 patients with injuries belong to type Ⅲ,6 patients with injuries belong to type Ⅳ; 14 cases of pronation-externa1 rotation,in which 6 patients with injuries belong to type Ⅲ,8 patients with injuries belong to type Ⅳ; and 12 cases of pronation-abduction,in which 4 patients with injuries belong to typeⅡ,8 patients with injuries belong to type Ⅲ. According to injury of ankle,4 patients had injuries in one ankle,28 patients had injuries in 2 ankles,and 12 patients had injuries in 3 ankles. All the patients were diagnosised definitely in sight of medical history,checking-up,iconography. The clinical effects were evaluated based on Baird-Jackson score and activity degree of ankle.
Results: All the patient were followed up,and the duration ranged from 11 to 23 months,with an average of 15.7 months. No postoperative wound infection,nonunion,and tibiofibular syndesmosis separation again and other complications occurred. Postoperative Baird-Jackson score exhibited 91.56 ± 6.26(75 to 99),and 26 patients got an excellent result,10 good,6 poor and 2 bad. One patient had nail broken after operation,and got good function after removing broken nail without external fixation. Other 1 patient had osteoarthritis to 1 degree,and got better result with the treatment of physical therapy and intra-articular injection.
Conclusion: Cortex screw is the effective treatment for tibiofibular syndesmosis separation. Clear diagnosis,delicate operation and postoperative reasonable functional exercise are primary factor of prognosis. |
| KEY WORDS Ankle joint Wounds and injuries Fracture fixation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 余斌峰,王伟良,林锡鹏.皮质螺钉治疗下胫腓联合分离伴踝关节骨折[J].中国骨伤,2015,28(7):663~665 |
| 英文格式: | YU Bin-feng,WANG Wei-liang,LIN Xi-peng.Treatment of tibiofibular syndesmosis together with ankle fracture using cortical screw[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(7):663~665 |
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