| 距骨骨折的手术治疗 |
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Received:May 23, 2006
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| 期刊信息：《中国骨伤》2007年20卷，第6期，第379-381页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的: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。
方法:本组距骨骨折39例,其中男29例,女10例;年龄23~55岁,平均32.5岁。骨折根据Hawkins分型
方法:Ⅰ型骨折5例,Ⅱ型骨折25例,Ⅲ型骨折9例。Ⅰ型骨折采用松质骨拉力螺钉内固定。Ⅱ、Ⅲ型骨折行急诊手术,其中Ⅱ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;Ⅲ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。
结果:除2例失访外,37例获得随访。随访时间1.5~6年,平均3年。根据Hawkins疗效标准评定:优12例(32.4%),良17例(45.9%),可6例(16.2%),差2例(5.4%),优良率为78.4%。
结论: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。 |
| [关键词]:距骨 骨折 并发症 骨折固定术 |
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| Surgery treatment for the fracture of talus |
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Abstract:
Objective: To study the characteristics,classification,operative methods and related factors influencing therapeutic effects of fractures of the talus.
Methods: Thirty-nine patients(29 male and 10 female,ranging in age from 23 to 55 years,with an average of 32.5 years)with fracture of the talus were treated in the study.According to Hawkins classification,there were 5 type Ⅰ,25 type Ⅱand 9 type Ⅲ fractures.Cancellous lag screw fixation was adopted in the treatment of patients with type Ⅰ fracture,and emergence operation was applied to patients with type Ⅱ and Ⅲ fractures.The patients with type Ⅱ fractures were treated with anterior and lateral approach,anatomic reduction and fixation with two cancellous lag screws placed perpendicular,and patients with type Ⅲ fractures were treated with anterior and medial approach,anatomic reduction and fixation with two lag screws.If the patients were accompanied by the fracture of malleolus medialis,the patients were treated with reduction and fixation at the same time,and impacted iliac autograft spaning the fracture line.After operation,all the patients were immobilized with short leg plaster cast for 12 to 24 weeks till the X-ray showed unsharp fracture line.Then non-weight-bearing exercises of ankle joint were performed,and actions recovered to normal after fracture line disappeared.
Results: Except 2 patients,other 37 patients were followd up from 1.5 to 6 years,with an average of 3 years.According to Hawkins criteria standard,the results were excellent in 12 patients(32.4%),good in 17 patients(45.9%),fair in 6 patients(16.2%)and poor in 2 patients(5.4%),the excellent and good rate was 78.4%.
Conclusion: The complications of fracture of talus can be reduced by using combined therapy,such as emergency surgery,anatomic reduction,effective internal fixation,impacted iliac autograft,local blockage and physical therapy. |
| KEYWORDS:Talus Fractures Complications 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: | 吴国正.距骨骨折的手术治疗[J].中国骨伤,2007,20(6):379~381 |
| 英文格式: | WU Guo-zheng.Surgery treatment for the fracture of talus[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(6):379~381 |
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