期刊文献+

经后外侧入路切开复位内固定与闭合复位内固定在后踝骨折中的疗效观察 被引量:15

Observation on effect of open reduction internal fixation and closed reduction internal fixation by posterolateral approach in treating posterior malleolus fracture
下载PDF
导出
摘要 目的观察经后外侧入路切开复位内固定与闭合复位内固定治疗后踝骨折的疗效。方法选择该院2013年4月至2015年10月行手术治疗的合并后踝骨折的35例踝关节骨折患者,其中经后外侧入路切开复位内固定25例(切开复位组),闭合复位内固定10例(闭合复位组)。观察两组患者手术时间、术后非负重时间、骨折愈合时间。术后12个月采用Olerud-Molander踝关节功能评分系统对两组患者的踝关节功能进行比较。结果切开复位组患者的手术时间、术后骨折愈合时间较闭合复位组长,差异有统计学意义(P<0.05)。切开复位组与闭合复位组患者术后4周可逐渐下地适当负重,两组患者非负重时间差异无统计学意义(P>0.05)。所有手术患者均在5~7个月内获得骨性愈合。切开复位组患者踝关节功能评分为(83.51±8.44)分,闭合复位组为(80.83±9.61)分,差异无统计学意义(P>0.05)。结论经后外侧入路切开复位内固定与闭合复位内固定在治疗后踝骨折中的临床效果相近。切开复位内固定手术时间长,骨折部位软组织损伤重;闭合复位内固定技术要求高,术中情况复杂。对于后踝骨折块较大且受伤时间较短的患者可首选闭合复位内固定治疗,对于后踝骨折块较小或医师闭合复位操作经验较少的情况下尽量选用切开复位内固定治疗。 Objective To observe the effect of open reduction internal fixation and closed reduction internal fixation by posterolateral approach for treating posterior malleolus fracture.Methods The patients with complicating posterior malleolus fracture treated in the hospital from April 2013 to October 2015 were selected,including 25 cases of open reduction internal fixation by posterolateral approach(open reduction group)and 10 cases of closed reduction internal fixation(close reduction group).The operation time,fracture healing time and postoperative non-weight-bearing time were observed in the two groups.The ankle joint functions in postoperative 12 months were compared between the two groups according to the Olerud-Molander ankle joint function scoring system.Results The operating time and facture healing time in the open reduction group were longer than those in the close reduction group,the differences were statistically significant(P<0.05).The patients in the two groups gradually began to get out of bed and conduct the proper bear loading in postoperative 4 weeks.The postoperative non-weight-bearing time had no statistical difference between the two groups(P>0.05).All operated cases obtained the clinical healing within 5-7 months.The ankle joint functions score in the open reduction internal fixation group was(83.51±8.44)points,which in the close reduction group was(80.83±9.61)points,and the difference was not statistically significant(P>0.05).Conclusion The clinical effect of open reduction internal fixation by posterolateral approach is similar to that of closed reduction internal fixation in the treatment of ankle fracture.The operation time of open reduction internal fixation is long,local soft tissue injury is heavy,closed reduction internal fixation requires high technology,and the intraoperation situation is complex.For the patients with large posterior malleolus fracture pieces and short injury time,the close reduction internal fixation may be the first selection,under the condition of small posterior malleolus fracture pieces or less experience of closed reduction operating,the open reduction should be selected as much as possible.
作者 郎林 贾忠宝 王计辰 LANG Lin;JIA Zhongbao;WANG Jichen(Department of Orthopedics,Fengtai District Nanyuan Hospital,Beijing 100076,China)
出处 《检验医学与临床》 CAS 2020年第6期798-800,共3页 Laboratory Medicine and Clinic
关键词 后踝骨折 切开复位 闭合复位 posterior malleolus fracture open reduction closed reduction
  • 相关文献

参考文献14

二级参考文献102

  • 1郭荣光,王强,孙建华,李海波.三踝骨折合并下胫腓联合分离治疗[J].中国矫形外科杂志,2004,12(14):1061-1062. 被引量:29
  • 2康维杰,郑连党.螺钉结合管型钢板治疗三踝骨折[J].中国骨与关节损伤杂志,2005,20(4):280-281. 被引量:26
  • 3林希龙,祝勇,王岩峰.螺旋CT和三维重建技术在三踝骨折治疗中的应用[J].中国矫形外科杂志,2006,14(10):755-756. 被引量:12
  • 4Jensen SL, Andresen BK, Mencke S, et al. Epidemiology of ankle fractures. A prospective population-based study of 212 cases in Aalborg, Denmark. Acta Orthop Scand, 1998, 69(1): 48-50.
  • 5Jaskulka RA, Ittner G, Schedl R. Fractures of the posterior tibial margin: their role in the prognosis of malleolar fractures. J Trauma, 1989, 29(11): 1565-1570.
  • 6Broos PL, Bisschop AP. Operative treatment of ankle fractures in adults: correlation between types of fracture and final results. Injury, 1991, 22(5): 403-406.
  • 7McDaniel WJ, Wilson FC. Trimalleolar fractures of the ankle. An end result study. CI in Orthop Relat Res, 1977, ( 122 ): 37-45.
  • 8Calhoun JH, Li F, Ledbetter BR, et al. A comprehensive study of pressure distribution in the ankle joint with inversion and eversion. Foot Ankle Int, 1994, 15(3): 125-133.
  • 9Ihn JC, Kim SJ, IH P. In vitro study of contact area and pressure distribution in the human knee after partial and total meniscectomy. Int Orthop, 1993, 17(4): 214-218.
  • 10Stauffer RN, Chao EY, Brewster RC. Force and motion analysis of the normal, diseased, and prosthetic ankle joint. Clin Orthop Relat Res, 1977, (127): 189-196.

共引文献223

同被引文献154

引证文献15

二级引证文献11

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部