摘要
背景:距骨颈骨折临床发病率低,传统行切开复位内固定后距骨缺血性坏死、创伤性踝关节炎发生率较高;减少医源性距骨血供破坏并实现骨折解剖复位以及坚强内固定是临床上治疗距骨颈骨折的研究方向。目的:探讨闭合复位经皮内固定治疗距骨颈骨折的方法及临床疗效。方法:回顾性分析2016年9月至2018年3月收治的采用闭合复位经皮内固定治疗的距骨颈骨折患者11例,共11足。观察术后并发症发生及骨愈合情况;随访时采用Maryland足踝部功能评分、行走1 km后疼痛视觉模拟评分(VAS)评价足部功能。结果:11例患者均获得随访,随访时间13~28个月,平均随访(21.1±4.1)个月。本组病例均达到骨性愈合,愈合时间8~12周,平均(9.7±1.4)周;未见骨不连、骨折畸形愈合、内固定断裂及距骨缺血性坏死等并发症发生。末次随访时Maryland足踝部功能评分为(98.2±3.4)分,优良率为100%;末次随访行走1 km后疼痛VAS评分为(0.4±0.7)分,其中完全无疼痛8例。结论:闭合复位经皮内固定治疗距骨颈骨折临床疗效满意,并发症发生率低。
Background: The clinical incidence of talar neck fractures is very low, but avascular necrosis of talus and traumatic ankle arthritis often occur after open reduction and internal fixation for talar neck fractures. Therefore, research directions are focused on reducing iatrogenic talus blood supply destruction and achieving anatomical reduction and rigid internal fixation. Objective: To explore the method and clinical effect of closed reduction and percutaneous internal fixation for talus neck fractures. Methods: From September 2016 to March 2018, 11 patients(11 feet) with talus neck fractures were treated with closed reduction and percutaneous internal fixation. The occurrence of complications and bone healing were observed. Foot function was evaluated by Maryland ankle function score and VAS pain score after walking one kilometer during follow-up. Results: The mean duration of follow-up was(21.1±4.1) months(range, 13-28 months) in all the 11 patients. Bone union was achieved in all of them, and the mean healing time was(9.7±1.4) weeks(range, 8-12 weeks). No complications such as nonunion, malunion, rupture of internal fixation or ischemic necrosis of the talus were found. At the last follow-up, Maryland ankle function score was 98.2±3.4 on average, and excellent rate was 100%. The mean VAS score was0.4±0.7 after walking one kilometer at the last follow-up, and no pain occurred in 8 patients. Conclusions: Percutaneous reduction and internal fixation is effective in the treatment of talus neck fractures and has a low incidence of complications.
作者
张言
梁景棋
郑伟鑫
杨谢安
赵宏谋
ZHANG Yan;LIANG Jingqi;ZHENG Weixin;YANG Xiean;ZHAO Hongmou(Clinical Center of Foot and Ankle Orthopaedics,Honghui Hospital,Xi'an Jiao Tong University,Xi'an 710054;Xi'an Medical University,Xi'an 710021;Shaanxi University of Chinese Medicine,Xianyang 712046,Shaanxi,China)
出处
《中华骨与关节外科杂志》
2020年第7期529-533,共5页
Chinese Journal of Bone and Joint Surgery
关键词
距骨颈骨折
闭合复位
经皮内固定
Talar Neck Fractures
Closed Fixation
Percutaneous Internal Fixation
