摘要
目的探讨带线铆钉联合空心钉治疗Tillaux-Chaput结节粉碎性骨折伴下胫腓分离的应用效果。方法选取2017年1月至2020年1月在河南省中医院创伤骨科住院治疗的Tillaux-Chaput结节粉碎性骨折伴下胫腓联合分离的患者18例,所有患者均有Tillaux-Chaput结节粉碎性骨折、腓骨骨折、内踝骨折及下胫腓联合分离。以锁定接骨板和锁定螺钉固定腓骨骨折,Tillaux-Chaput结节粉碎性骨折及下胫腓分离以1枚双线铆钉固定,以2枚空心螺钉固定内踝骨折。末次随访时行DR检查,测量下胫腓联合重叠宽度、内踝间隙,记录患侧足背屈跖屈角度,与健侧比较;根据美国足踝外科协会踝与后足功能评分系统(AOFAS)评价踝关节功能及优良率。结果术后所有患者骨折达骨性愈合,愈合时间12~20周,平均(14.78±2.05)周。末次随访时所有患者踝关节正位DR下胫腓联合重叠区域宽度平均(7.81±0.53)mm,内踝间隙(2.59±0.13)mm,患侧足跖屈(44.56±3.07)°,背屈(23.67±1.85)°,患侧以上指标与健侧比较,差异无统计学意义(P>0.05)。末次随访AOFAS评分61~100分,平均(91.67±11.42)分,其中优11例,良6例,可1例,优良率为94.4%。结论带线铆钉联合空心钉治疗Tillaux-Chaput结节粉碎性骨折伴下胫腓分离可减小手术创伤,不影响患者踝关节功能恢复,疗效显著。
Objective To investigate the effect of threaded rivets combined with hollow nails in the treatment of comminuted fractures of Tillaux-Chaput nodules with inferior tibiofibular syndesmosis separation.Methods Eighteen patients with comminuted fractures of Tillaux-Chaput nodules with inferiortibiofibular syndesmosis separation who were admitted in the Department of Traumatology and Orthopedics of Traditional Chinese Medicine Hospital of He'nan Province from January 2017 to January 2020 were selected,all of whom had comminuted fractures of Tillaux-Chaput nodules,fibula fractures,medial malleolus fractures,and inferiortibiofibular syndesmosis separation.The fibula fractures were fixed with locking bone plates and locking screws,the comminuted fracture of Tillaux-Chaput nodules and the inferior tibiofibular syndesmosis separation were fixed with a double-line rivet,and the medial malleolus fracture was fixed with 2 hollow screws.At the last follow-up,DR examination was performed to measure the overlap width of the inferior tibiofibular syndesmosis and the medial malleolus gap,and record the dorsiflexion and plantar flexion angle of the affected side and compare it with the healthy side.According to the American Orthopaedic Foot and Ankle Society(AOFAS)Ankle-Hindfoot Score,the ankle joint function and the excellent and good rate were evaluated.Results All patients had fractured bone union after operation.The healing time was 12-20 weeks,with an average of(14.78±2.05)weeks.At the last follow-up,all patients had an average width of(7.81±0.53)mm in the overlapping area of the inferior tibiofibular syndesmosis with DR of the ankle joint,and(2.59±0.13)mm of the medial malleolus gap.The plantar flexion of the affected foot was(44.56±3.07)°,and the dorsiflexion was(23.67±1.85)°,There were no significant differences between the above-mentioned indicators in the affected side and the healthy side(P>0.05).At the last follow-up,the AOFAS score was 61-100 points,with an average of(91.67±11.42)points,in which 11 cases were excellent,6 cases were good,and 1 case was fair.The excellent and good rate was 94.4%.Conclusion Threaded rivets combined with hollow nails in the treatment of comminuted fractures of Tillaux-Chaput nodules with inferiortibiofibular syndesmosis separation is able to reduce surgical trauma without affecting the recovery of the patients'ankle joint function,which has signi ficant efficacy.
作者
程帅榜
曹玉净
齐秀春
李扬
朱梓宾
刘超
CHENG Shuaibang;CAO Yujing;QI Xiuchun;LI Yang;ZHU Zibin;LIU Chao(The Second Clinical Medical School of He'nan University of Chinese Medicine,He'nan,Zhengzhou 450056,China;Emergency Trauma Center,the Second Affiliated Hospital of He'nan University of Chinese Medicine,He'nan,Zhengzhou 450003,China)
出处
《中国医药科学》
2021年第12期17-21,共5页
China Medicine And Pharmacy
基金
河南省中医药科学研究专项课题(2017ZY1018)。
