摘要
目的对比不同大小后踝骨折块切开复位内固定术后复位程度及AOFAS评分,探讨后踝骨折的治疗策略。方法53例后踝骨折均行切开复位内固定手术,分析后踝骨折块<25%(A组)和≥25%(B组)胫骨远端关节面患者解剖复位率及末次随访时AOFAS评分差异。结果 53例均获随访18-29个月,平均23.19个月。A、B组胫骨远端关节面解剖复位率及末次随访时AOFAS评分差异均有统计学意义(P<0.05)。但解剖复位组及非解剖复位组末次随访时AOFAS评分差异无统计学意义(P>0.05)。结论当后踝骨折块≥25%胫骨远端关节面或移位大于2 mm时应尽量行切开复位内固定手术治疗;当外踝已经完全复位、距骨脱位完全矫正,即使后踝骨折块<25%胫骨远端关节面也应该复位并固定后踝,且骨折复位固定的顺序为:外踝、后踝、内踝。
Objective To compare the rate of anatomic reduction and score of AOFAS in different size of posterior maUeolar fracture after carrying out the open reduction and internal fixation, as well as invest/gating the strategy of management of posterior malleolar fracture. Methods Fifty-three patients received open reduction and internal fixation surgical treatment of a posterior malleolar fracture, the discrepancy between the rate of anatomic reduction and score of AOFAS in different size of posterior malleolar was analyzed, which was ≤25% （group A） and ≥25%（group B） of the distal tibial articular surface as viewed on the lateral radiograph. Results All of the 53 patients were followed up for 18 to 29 months, with an average of 23.19 months. The differences between group A and B in the rate of anatomic reduction and score of AOFAS were of statistical significant. But there was no statistical difference in AOFAS score between anatomic reduction and nonanatomic reduction（P 〉 0.05）. Conclusion If the posterior malleolar fracture is ≥25% of the articular surface or displaced 〉2 mm, the fractures should be fLxed. If the lateral malleolar is fixed and the talus is still dislocated, even though the posterior malleolar fracture is 〈25% of the articular surface, the small fragment should be fixed, and the order of the fracture fixing is： external ankle, post ankle and medial maUeolus.
出处
《中国骨与关节损伤杂志》
2013年第2期125-127,共3页
Chinese Journal of Bone and Joint Injury
关键词
后踝骨折
解剖复位
内固定
Posterior malleolar fracture
Anatomical reduction
Internal fixation
