摘要
目的探讨踝关节骨折合并WagstaffeⅢ型骨折的临床特点及手术疗效。方法笔者自2009-01—2016-01诊治10例合并WagstaffeⅢ型骨折的踝关节骨折。依据后踝骨折与否采用前外侧或后外侧入路,复位腓骨骨折后以钢板固定,复位WagstaffeⅢ型骨块后以空心钉固定或粗丝线缝合,采用内侧弧形切口显露内踝骨折,复位后以空心钉固定,如WagstaffeⅢ型骨折块无法坚强内固定则加用石膏外固定4周。结果所有患者获得随访10~24个月,平均14.2个月。术后X线片示踝关节均骨性愈合,关节间隙正常。愈合时间15~28周,平均16.7周。末次随访时疗效按Baird-Jackson踝关节功能评分评定:平均93.5(83~99)分;优5例,良3例,可2例。结论 WagstaffeⅢ型骨折较为少见,容易漏诊,准确复位及个体化内、外固定结合可有效促进患者术后功能恢复,减少创伤性关节炎的发生。
Objective To explore the clinical characteristics and surgical curative effect of ankle fractures with Wagstaffe mtype fractures. Methods The data of 10 patients who suffered the ankle fractures combined with the Wagstaffe type IUfractures between January 2009 and January 2016 were analyzed. Based on whether there was posterior malleolus fracture ornot anterolateral or posterolateral approach was used. The fibula fractures was fixed with plate. Wagstaffe and Tillaux-Chaputfractures were treated by hollow screw or thick suture fixation. The medial malleolar fracture was explored through medialcurve approach, with the hollow screw fixation after reset. The external fixation of plaster was used for 4 weeks if internalfixation for Wagstaffe and Tillaux-Chaput fracture was not rigid. Results All patients were followed up for 10-24 months（average, 14.2 months）. All radiographs showed union of all fractures and normal mortises. The fracture healed 15-28 weekslater in all the 10 patients, with an average of 16.7 weeks. Baird-Jackson ankle functional score was from 83 to 99. In allpatients, 5 were rated as excellent, 3 as good and 2 as fair. Conclusion As an uncommon injury, Wagstaffe type IU fracturescould be easily missed in diagnosis. Accurate anatomical restoration and individualization of methods of internal or externalfixation can effectively improve patients postoperative functional recovery, reduce the occurrence of traumatic arthritis.
出处
《中国骨与关节损伤杂志》
2017年第12期1262-1265,共4页
Chinese Journal of Bone and Joint Injury
