摘要
目的对足踝部急性损伤的评估、治疗要点及相关进展进行评述。方法根据临床治疗经验和近期文献报道结果,对常见的足踝部损伤,包括软组织损伤和骨性损伤的相关基础研究结果、术前评估、合理及个体化的治疗方案选择进行分析评述,并对相关临床报道进行总结。结果足踝部急性损伤的修复仍是临床和基础研究的热点。急性跟腱断裂手术与非手术治疗均可获得较为满意的疗效,早期负重并不增加再断裂发生率。足踝部开放性损伤首次清创时机延迟至24 h以内并不显著增加感染的发生率。在治疗严重踝部骨折时,应注意是否存在软骨损伤,解剖复位、纠正力线和恢复关节协调性是获得良好预后的前提。跟骨骨折治疗方案的确定依赖于对跟骨骨折损伤机制、分型及各种治疗方法的充分理解。距骨骨折的手术治疗尽量由经验丰富的医师完成。Lisfranc损伤应根据不同的损伤类型选择合理的手术及固定方案。结论足踝部急性损伤临床常见,对损伤的正确评估、手术时机和治疗方式的合理选择以及对特殊部位损伤和力学机制的正确认识,对获得良好治疗结果有重要意义。
Objective To give a review and commentary on the treatment of acute toot and ankle injuries. Methods Based on the treatment experience and recent literature, a commentary on acute foot and ankle injuries were given, included the basic and clinical research results, evaluation before operation, and treatment methods of the soft tissue and bone injuries. Results The treatment of acute foot and ankle injuries is still a hot point in orthopaedic surgery. Operative and non-operative treatment of fresh Achilles tendon rupture can achieve satisfactory results, and early weight-bearing do not increase the re-rupture rate. The time delay between first debridement and injury within 24 hours does not increase the infection rate. For the treatment of severe ankle fractures, attentions should be paid to the cartilage injury, and anatomic reduction, good realignment, and the congruity recovery are very important. The treatment determination of calcaneal fractures depends on the fully understanding injury mechanisms, classifications, and treatment method. Talus fractures should try to be treated by experienced surgeons. Operation and fixation methods of Lisfranc injury depends on different injury types. Conclusion Acute foot and ankle injuries are common in clinical, to achieve a satisfactory result in evaluation and treatment, it is important to have a fully evaluation of the injury type, and choose the best operation time and suitable treatment methods, as well as to fully understand the biomechanical characteristics of different regions.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2011年第7期769-773,共5页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
足踝部
急性损伤
评估
治疗
进展
Foot and ankle Acute injury Assessment Treatment Progress
