摘要
目的回顾性分析保守治疗与切开复位内固定治疗距骨颈骨折的疗效。方法对1998年1月～2004年11月收治的23例距骨颈骨折中获得随访的18例进行回顾性分析。所有骨折均按Hawkins分型:Ⅰ型4例,Ⅱ型11例,Ⅲ型3例。Ⅰ型骨折采用石膏外固定保守治疗,Ⅱ、Ⅲ型骨折采用切开复位内固定治疗。结果随访1～7年,平均3.4年。采用Hawkins评分:优7例(Ⅰ型3例,Ⅱ型4例),良4例(Ⅰ型1例,Ⅱ型3例),中4例(Ⅱ型3例,Ⅲ型1例),差3例(Ⅱ型1例,Ⅲ型2例),优良率为61.1%。合并切口皮缘坏死2例,感染1例,均为开放性骨折。内翻畸形2例,距骨缺血坏死2例,足踝及距下关节创伤性关节炎3例,骨折延迟愈合1例,2例术后1年行Blair融合术。结论术前正确分析骨折类型、选择恰当的手术入路、解剖复位、稳定内固定是提高距骨颈骨折治疗效果的关键。
Objective To retrospectively evaluate long-term results of surgical treatment of displaced talar neck fractures with stable internal fixation. Methods Twenty-three cases of talar neck fractures were treated in our department from January 1998 to November 2000, Eighteen of them who had been followed up were retrospective reviewed. Based on the Ⅱawkins classification, there were four cases of type Ⅰ, 11 of type Ⅱ and three of type Ⅲ, The type Ⅰ patients were treated non-operatively, and immobilized with plaster splint. All the patients of type Ⅱ and type Ⅲ were treated with open reduction internal fixation （ORIF）, Results The follow-ups ranged from one to seven years, averaging 40 months. According to Hawkins evaluation system, seven cases were assessed as excellent （three type Ⅰ and four type Ⅱ）, four as good （one type Ⅰ and three type Ⅱ）, four as fair （three type Ⅱ and one type Ⅲ ）, and three as poor （one type Ⅱ and two type Ⅲ ） , The good-to-excellent rate was 61.1%. Three cases of open fracture reported necrosis of skin （two） and infection （one）. There were two cases of varus abnormity, two cases of osteonecrosis, three cases of traumatic arthritis of subtalar joint, and one case of delayed union, Two cases had to receive Blair fusion one year postoperatively, Conclusion According to our experience, accurate analysis of fracture type preoperatively, reasonable design of surgical approach and timing of surgery are essential to successful treatment of talar neck fractures.
出处
《中华创伤骨科杂志》
CAS
CSCD
2006年第5期430-433,共4页
Chinese Journal of Orthopaedic Trauma
基金
云南省科技攻关项目(2005NG10)
云南省教育厅科学研究基金项目(N:5Z1409C)
关键词
距骨
骨折
骨折固定术
内
保守治疗
Talar
Fracture
Fracture fixation, internal
Non-operatively
