摘要
目的探讨胫腓远端骨折术后骨性连接部位特点及其对踝关节功能的影响。方法回顾性分析2014年2月—2018年10月于江苏省徐州仁慈医院就诊的74例胫腓远端骨折术后骨性连接患者的临床资料及影像学资料。分析其影像学资料及并发症发生情况,比较末次随访时患侧与健侧踝关节活动度及美国足踝骨科协会(AOFAS)评分。结果53例胫腓骨远端骨折累及踝关节者中骨性连接发生在下胫腓联合水平的有48例,14例单纯胫腓骨远端骨折中骨性连接发生位于骨折线部位的有11例,4例胫骨干合并外踝骨折骨性连接发生在胫骨髓内针远端锁钉部的有2例,3例Pilon骨折骨性连接均发生在骨折线部位。末次随访时,患侧踝关节跖屈、主动背伸、被动背伸活动度及AOFAS评分均低于健侧,差异有统计学意义(均P<0.05)。14例患者发生不良反应,包括螺钉断端移位、针道感染、踝关节活动度减小或骨关节炎征象、劳力后患侧酸痛及上下楼梯略感不适。结论胫腓远端骨折术后骨性连接多发生在骨折线部位,踝关节骨折患侧踝关节活动度低于健侧,但不影响日常生活和工作。
Objective To investigate the characteristics of bony junction after distal tibiofibular fracture and its effect on ankle joint function.Methods The clinical data and imaging data of 74 patients with bony junction after distal tibiofibular fracture in Xuzhou Renci Hospital,Jiangsu Province from February 2014 to October 2018 were retrospectively analyzed.The imaging data and the incidence of complications were analyzed,and the range of motion of the affected and healthy ankles and the American orthopedic foot ankle society(AOFAS)score were compared at the last follow-up.Results Among the 53 distal tibiofibular fractures involving the ankle joint,48 cases had bony junction at the tibiofibular syndesmosis level.Eleven of the 14 cases of simple distal tibionfibular fractures had bony junction at the fracture line,two of the four cases of tibia shaft combined with lateral malleolus fractures had bony junction at the locking nail at the distal end of the tibial intramedullary needle,and three cases of Pilon fracture had bony junction at the fracture line.At the last follow-up,the range of motion of plantar flexion,active dorsal extension,passive dorsal extension and AOFAS score of the affected side were lower than those of the healthy side,with statistical significance(all P<0.05).Adverse reactions occurred in 14 patients,including displacement of the broken end of the screw,needle tract infection,reduced range of motion or signs of osteoarthritis in the ankle,post-exertion soreness on the affected side,and slight discomfort in walking up and down stairs.Conclusion The bony junction of distal tibiofibular fracture occurs mostly in the fracture line,and the range of motion of the affected side of the ankle is lower than that of the healthy side,but it does not affect the daily life and work.
作者
杨文一
祁良
YANG Wenyi;QI Liang(Department of Radiology,Xuzhou Renci Hospital,Jiangsu Province,Xuzhou 221000,China;Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province,Nanjing 210029,China)
出处
《中国医药导报》
CAS
2021年第18期100-102,共3页
China Medical Herald
基金
江苏省青年基金资助项目(BK20171086)。
关键词
胫腓远端骨折
术后骨性连接
影像学
踝关节功能
Distal tibiofibular fracture
Postoperative bony junction
Imageology
Ankle function
