摘要
目的探讨改良后内侧入路治疗三踝骨折的临床疗效。方法前瞻性研究淮南市第一人民医院创伤骨科2015年6月-2017年6月收治的三踝骨折患者21例,其中男性15例,女性6例;年龄19~52岁,平均37.2岁。根据Lauge-Hansen分型:旋后外旋型16例,旋前外旋型3例,旋前外展型2例;其中3例为开放性骨折(2例GustiloⅠ型,1例GustiloⅡ型)。均使用标准外踝切口固定外踝,采用改良后内侧入路固定内、后踝。记录患者手术时间、术中出血量以及术后并发症发生情况,术后均进行不少于6个月门诊随访,记录末次患者踝关节Baird-Jackson评分。结果所有患者手术顺利,且均获得10~15个月(平均12个月)门诊随访,术后出现4例切口浅表感染,无其他手术并发症,末次随访踝关节功能Baird-Jackson评分优12例,良7例,可1例,差1例;优良率90%。结论改良后内侧入路在处理内、后踝具有潜在优势,可作为处理三踝骨折的一种方法。
Objective To explore the clinical effect of modified posterior medial approach in the treatment of ankle fractures.Methods Twenty-one patients with ankle fractures were treated in Department of Traumatology and Orthopaedics,Huainan First People s Hospital from Jun.2015 to Jun.2017.There are 15 males and 6 females with an average age of 37.2 years(range,19-52 years).The Lauge-Hansen classification showed 16 cases of postrotation type,3 cases of pronation type and 2 cases of pronation outreach type.There were 3 cases of open fractures(2 cases were GustiloⅠ,1 case was GustiloⅡ).The lateral malleolus was fixed with a standard lateral malleolus incision,and the medial and posterior malleolus was fixed with modified posterior medial approach.The operation time,blood loss and postoperative complications were recorded.All patients were followed up for no less than 6 months after operation.The Baird-Jackson score of the ankle at the last follow-up was recorded.Results All patients underwent successful surgery,with an average of 12(10-15)months.In the outpatient follow-up,4 cases of superficial incision infection occurred after operation,and there was no other surgical complication.The Baird-Jackson score of ankle function was excellent in 12 cases,good in 7 cases,fair in 1 case,and poor in 1 case,with the excellent and good rate of 90%.Conclusion The modified posterior medial approach has potential advantages in the treatment of the medial and posterior ankles,and can be used as a method for the treatment of ankle fractures.
作者
姚鹏飞
李强
董斌
崔海勇
徐高伟
张乐
彭成
王昊
YAO Peng-fei;LI Qiang;DONG Bin;CUI Hai-yong;XU Gao-wei;ZHANG Le;PENG Cheng;WANG Hao(the First Affiliated Hospital of Anhui University of Science and Technology,Huainan First People's Hospital,Huainan,Anhui 232052,China)
出处
《创伤外科杂志》
2020年第1期56-58,共3页
Journal of Traumatic Surgery
基金
安徽省淮南市科技项目(编号:2018A3611)
关键词
三踝骨折
内侧入路
关节功能
malleolar fracture
posterior medial approach
joint function
