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手法复位经皮穿针内固定治疗旋后外旋型Ⅳ度踝部骨折
Hits: 2137   Download times: 1168   Received:February 19, 2017    
作者Author单位UnitE-Mail
李嘉 LI Jia 文登整骨医院, 山东 文登 264400 Wendeng Osteopath Hospital, Wendeng 264400, Shandong, China 33844044@qq.com 
孙晋客 SUN Jin-ke 文登整骨医院, 山东 文登 264400 Wendeng Osteopath Hospital, Wendeng 264400, Shandong, China  
王晨霖 WANG Chen-lin 文登整骨医院, 山东 文登 264400 Wendeng Osteopath Hospital, Wendeng 264400, Shandong, China  
期刊信息:《中国骨伤》2017年30卷,第6期,第499-502页
DOI:10.3969/j.issn.1003-0034.2017.06.003


目的:探讨旋后外旋型Ⅳ度踝部骨折手法复位经皮穿针内固定治疗的手术技巧,并分析其疗效。

方法:自2013年5月至2016年10月采用手法复位经皮穿针内固定治疗35例旋后外旋型Ⅳ度踝部骨折患者,男22例,女13例;年龄18~65岁,平均38.2岁。受伤至手术2 h~10 d,平均5 d.采用Burwell-Charnley放射学复位标准评定骨折复位质量。根据Baird-Jackson踝关节评分系统进行疗效评定。

结果:术后33例患者获得随访,时间10~28个月,平均14个月。骨折于术后10~18周(平均12周)达到临床愈合标准。根据Burwell-Charnley放射学复位标准评定复位质量:解剖复位30例,复位可3例。根据Baird-Jackson评价系统,总分93.8±5.4,其中优17例,良12例,可2例,差2例。

结论:手法复位经皮穿针内固定治疗旋后外旋型Ⅳ度踝部骨折疗效确切,并发症少,但对术者闭合整复技术手法要求较高;骨折端粉碎严重及关节面压缩骨折不适用于该术式。
[关键词]:手法,骨科  骨折固定术,内    骨折
 
Manipulative reduction and percutaneous Kirschner wire internal fixation for grade Ⅳ supination-external rotation ankle fractures
Abstract:

Objective: To investigate surgical skills and clinical effects of manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade Ⅳ supination-external rotation ankle fractures.

Methods: From May 2013 to October 2016,35 patients with grade Ⅳ supination-external rotation ankle fractures were treated with percutaneous Kirschner wire internal fixation,involving 22 males and 13 females with an average age of 38.2 years ranged from 18 to 65 years old. The time from injury to operation ranged from 2 h to 10 d with an average of 5 d. Reduction quality was assessed by Burwell-Charnley radiological criteria. Baird-Jackson ankle scoring system was used to assess clinical effects.

Results: Thirty-three patients were followed up from 10 to 28 months with an average of 14 months. Fracture healing time ranged from 10 to 18 weeks with an average of 12 weeks. According to Burwell-Charnley radiological criteria,30 cases were obtained anatomic reduction,3 cases moderate. According to Baird-Jackson ankle scoring system,total score was 93.8±5.4,17 cases got excellent result,12 good,2 fair and 2 poor.

Conclusion: manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade Ⅳ supination-external rotation ankle fractures has advantages of reliable efficacy,less complications. But higher require techniques were required for closed reduction. It is not suitable for severe crushed fracture and compressive articular surface fracture.
KEYWORDS:Manipulation,orthopedic  Fracture fixation,internal  Ankle  Fractures
 
引用本文,请按以下格式著录参考文献:
中文格式:李嘉,孙晋客,王晨霖.手法复位经皮穿针内固定治疗旋后外旋型Ⅳ度踝部骨折[J].中国骨伤,2017,30(6):499~502
英文格式:LI Jia,SUN Jin-ke,WANG Chen-lin.Manipulative reduction and percutaneous Kirschner wire internal fixation for grade Ⅳ supination-external rotation ankle fractures[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(6):499~502
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