摘要
目的:探讨Maisonneuve骨折(maisonneuve fractures of the fibula,MFF)的诊断和治疗特点,并评估其手术治疗的临床疗效。方法:自2017年3月至2018年6月,采用手术治疗15例MFF患者,其中男9例,女6例;年龄27~54(35.00±7.46)岁;受伤至手术时间5~8(6.33±1.04)d。所有骨折为新鲜闭合性损伤。观察患者术后骨性愈合时间及术后并发症情况,并于术后12个月采用美国足与踝关节协会(American Orthopaedic Foot and Ankle Society,AOFAS)评分评价患者术后踝关节功能恢复程度。结果:15例患者获得随访,时间12~28(17.00±3.79)个月。4例发生漏诊。所有骨折获得骨性愈合,时间4~6(4.80±0.94)个月。术后未出现切口感染、骨折延迟愈合或不愈合等并发症。术后12个月AOFAS评分为(90.23±7.27)分;其中优9例,良3例,可3例。结论:MFF是一类严重的不稳定的踝关节损伤类型,容易忽视腓骨高位骨折及下胫腓的分离而造成漏诊误诊,手术治疗可恢复下胫腓联合以及踝穴的解剖学关系,获得较满意的疗效。
Objective:To explore clinical diagnosis and treatment features of Maisonneuve fractures(maisonneuve fractures of the fibula,MFF),and evaluate its clinical effects.Methods:From March 2017 to June 2018,15 patients with MFF were treated with operation,including 9 males and 6 females,aged from 27 to 54 years old with an average of(35.00±7.46)years old,the time from injury to operation ranged from 5 to 8 days with an average of(6.33±1.04)days.All the fractures were fresh and closed injury.The time of bone union and postoperative complications were observed,and AOFAS score was used to evaluate recovery of ankle joint function at 12 months after operation.Results:All patients were followed up from 12 to 28 months with an average of(17.00±3.79)months.Four patients were misdiagnosed.All fractures were obtained bone union from 4 to 6 months with an average of(4.80±0.94)months.No postoperative complications such as infection,delayed union or nonunion occurred.Postoperative AOFAS score at 12 months was 90.23±7.27,among which 9 patients got excellent result,3 good,and 3 fair.Conclusion:Maisonneuve fracture is an unstable fracture.High fibular fracture and the separation of the lower tibia and fibula could be easily neglected,which could lead to misdiagnosis and missed care.Surgical treatment could recover anatomical relation of the lower tibia and fibula and ankle mortise,and obtain satisfying clinical effect.
作者
马岗
姜宏
张志刚
刘锦涛
马智佳
MA Gang;JIANG Hong;ZHANG Zhi-gang;LIU Jin-tao;MA Zhi-jia(Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou 215009,Jiangsu,China;不详)
出处
《中国骨伤》
CAS
CSCD
2020年第7期667-671,共5页
China Journal of Orthopaedics and Traumatology
基金
国家自然科学基金项目(编号:81473691)
苏州市产业技术创新专项项目(编号:SYSD2017193)
苏州市卫计委青年基金项目(编号:KJXW2016036)。
关键词
踝关节
骨折
踝损伤
治疗结果
Ankle joint
Fractures
Ankle injuries
Treatment outcome
