| 开放性距骨脱位的手术治疗 |
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Received:January 25, 2011
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| 作者 | Author | 单位 | Unit | E-Mail |
| 韩庆林 |
HAN Qing-lin |
南通大学附属医院骨科，江苏 南通 226001 |
Department of Orthopaedics, the Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China |
1975hanql@163.com |
| 王友华 |
WANG You-hua |
南通大学附属医院骨科，江苏 南通 226001 |
Department of Orthopaedics, the Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China |
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| 刘璠 |
LIU Fan |
南通大学附属医院骨科，江苏 南通 226001 |
Department of Orthopaedics, the Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China |
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| 期刊信息：《中国骨伤》2011年24卷，第7期，第597-599页 |
| DOI：10.3969/j.issn.1003-0034.2011.07.018 |
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目的：探讨手术治疗开放性距骨脱位的临床疗效。
方法：收集2001年6月至2008年7月资料完整的开放性距骨脱位患者11例，男8例，女3例；年龄19～52岁，平均39.5岁。按照Gustilo分型：Ⅰ型2例，Ⅱ型6例，ⅢA型 2例，ⅢB型1例。胫距关节脱位5例(其中合并距下关节脱位3例),距下关节脱位4例，距骨完全脱位2例。8例合并距骨不同部位骨折。所有患者均在伤后8 h内接受清创、复位内固定加石膏或外固定支架固定。术后6周去除外固定。X线提示骨折愈合后负重。随访时摄踝关节正侧位、足部正位X线片，并按照美国足踝外科协会(AOFAS)对后足功能评分标准从疼痛、功能、力线等方面进行评分。
结果：11例患者随访时间为10～15个月，平均13.8个月。8例合并不同部位骨折的患者均获得愈合，愈合时间4～7个月，平均4.3个月，无伤口及深部感染。距骨坏死2例，创伤性关节炎2例。末次随访时AOFAS评分为(71.3±8.6)分，其中疼痛(32.4±7.1)分，功能(31.0±15.7)分，力线(7.6±2.3)分。
结论：对于开放性距骨脱位，通过积极彻底清创可以避免感染的发生；早期复位和固定是治疗的关键。 |
| [关键词]:距骨 脱位 外科手术 回顾性分析 |
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| Surgical treatment for open dislocation of talus |
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Abstract:
Objective: To evaluate the clinical effects of surgical treatment for open dislocation of talus.
Methods: From June 2001 to July 2008,the complete data of 11 patients with open dislocations of talus were retrospectively analyzed,including 8 males and 3 females with an average age of 39.5 years(ranged 19 to 52). According to Gustilo typing,typeⅠwas in 2 cases,typeⅡin 6 cases,type ⅢA in 2 cases,type ⅢB in 1 case. Five cases were tibial astragaloid joint dislocation in which 3 cases associated with subtalar joint dislocation,4 cases were subtalar joint dislocation and 2 cases were total dislocation of talus. Among them,8 dislocations associated with talus fractures. All patients were treated with debridement,open reduction,internal fixation with K-wires or screws and external fixation with plaster or external fixator within 8 hours after injury. External fixations were removed at 6 weeks after operation. Partial weight bearing was permitted only when X-rays indicated bony healing. Clinical effects were evaluated according to AOFAS system and X-ray films during follow-up.
Results: The mean time of follow-up was 13.8 months(ranged 10 to 15 months). Eight patients with fractures obtained bone healing in 4-7 months with an average of 4.3 months. No infection of wound or deep tissue was found. At final follow-up,talus necrosis was in 2 cases and traumatic arthritis was in 2 cases. The AOFAS score was 71.3±8.6,among the total,the pain,function,alignment was respectively(32.4±7.1),(31.0±15.7),(7.6±2.3) scores.
Conclusion: Complete debridement may avoid infection in treating open dislocation of talus,early reduction and fixation is a key point during treatment. |
| KEYWORDS:Talus Dislocations Surgical procedures,operative Retrospective studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 韩庆林,王友华,刘璠.开放性距骨脱位的手术治疗[J].中国骨伤,2011,24(7):597~599 |
| 英文格式: | HAN Qing-lin,WANG You-hua,LIU Fan.Surgical treatment for open dislocation of talus[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(7):597~599 |
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