| 空芯加压螺钉联合外固定架治疗Hawkins Ⅲ、Ⅳ型距骨颈骨折 |
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投稿时间：2016-12-11
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| 作者 | Author | 单位 | Address | E-Mail |
| 王显勋 |
WANG Xian-xun |
湖北省中山医院骨科, 湖北 武汉 430033 |
Department of Orthopaedics, Zhongshan Hospital of Hubei Province, Wuhan 430033, Hubei, China |
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| 万昌涛 |
WAN Chang-tao |
湖北省中山医院骨科, 湖北 武汉 430033 |
Department of Orthopaedics, Zhongshan Hospital of Hubei Province, Wuhan 430033, Hubei, China |
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| 余黎 |
YU Li |
武汉大学中南医院骨科, 湖北 武汉 430071 |
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yulixx@163.com |
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| 期刊信息：《中国骨伤》2017年，第30卷，第5期，第470-474页 |
| DOI：10.3969/j.issn.1003-0034.2017.05.015 |
| 基金项目:湖北省卫生厅一般项目（编号：WJ2015MB128） |
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中文摘要:
目的：探讨采用空芯加压螺钉联合外固定架治疗Hawkins Ⅲ、Ⅳ型距骨颈骨折的治疗效果。
方法：2010年3月至2014年8月，采用切开复位空芯加压螺钉联合外固定架治疗Hawkins Ⅲ、Ⅳ型距骨颈骨折15例，其中男9例，女6例；年龄17～65岁，平均37.5岁。按Hawkins法分型：Ⅲ型9例，Ⅳ型6例。观察术后骨折愈合及距骨坏死情况，并用美国足踝外科协会踝与后足评分（AOFAS）评价踝足部功能恢复情况。
结果：所有患者获得随访，时间8～55个月，平均23.5个月。所有骨折获得骨性愈合，时间13～38周，平均 （17.99±6.81）周。术后发生创伤性关节炎7例，距骨坏死6例，其中HawkinsⅢ型2例，Ⅳ型4例。术后AOFAS评分为（61.80±18.75）分，其中优4例，良2例，可4例，差5例。
结论：Hawkins Ⅲ、Ⅳ型距骨颈骨折发生缺血坏死可能性大，应用空芯加压螺钉联合外固定架治疗，踝关节晚负重，充分保证骨折愈合时间，可以获得满意的疗效。 |
| 【关键词】距骨骨折 切开复位 骨折固定术 缺血性坏死 |
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| Surgical treatment for talar neck fracture of Hawkins Ⅲ, Ⅳ type with compression hollow screws combined with external fixator |
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ABSTRACT
Objective: To investigate the clinical effects of compression hollow screws combined with external fixator in treating talar neck fracture of Hawkins Ⅲ, Ⅳ type.
Methods: From March 2010 to August 2014,15 patients with talar neck fractures of Hawkins Ⅲ, Ⅳ type were treated by open reduction and compression hollow screws fixation complicated with external fixator fixation. Including 9 males and 6 females,aged from 17 to 65 years old with an average of 37.5 years old. There were 9 cases of Hawkins Ⅲ and 6 cases of HawkinsⅣ type. Postoperative radiographs and CT of ankle were used to evaluate the fracture healing and talar necrosis. The function of ankle and foot were evaluated by American Society of Ankle and Foot Surgery(AOFAS).
Results: All the patients were followed up for 8 to 55 months with an average of 23.5 months and all fractures got bone healing from 13 to 38 weeks with an average of (17.99±6.81) weeks. Traumatic arthritis occurred in 7 cases and talar necrosis in 6 cases (2 cases of type Ⅲ and 4 cases of type Ⅳ) after operation. The average AOFAS score was 61.80±18.75,including excellent in 4 cases,good in 2 cases,fair in 4 cases and poor in 5 cases.
Conclusion: Talar neck fracture with Hawkins Ⅲ, Ⅳ type has large possibility to develop avascular necrosis. Hollow compression screw combined with external fixation may late weight-bearing for ankle and can sufficiently guarantee bone healing time,and achieve good results for the treatment of talar neck fracture. |
| KEY WORDS Talus fractures Open reduction Fracture fixation Avascular necrosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王显勋,万昌涛,余黎.空芯加压螺钉联合外固定架治疗Hawkins Ⅲ、Ⅳ型距骨颈骨折[J].中国骨伤,2017,30(5):470~474 |
| 英文格式: | WANG Xian-xun,WAN Chang-tao,YU Li.Surgical treatment for talar neck fracture of Hawkins Ⅲ, Ⅳ type with compression hollow screws combined with external fixator[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(5):470~474 |
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