摘要
目的 探讨距骨颈骨折的治疗及愈后。 方法 随访 89例住院治疗的距骨颈骨折患者 ,其中陈旧骨折 15例 (16 9% ) ,并按改良的Hawkin′s法进行分型 ,其中Ⅰ型 3例 ,行石膏及闭合克氏针固定 ;Ⅱ型 5 3例 ,行切开复位内固定 ,闭合复位石膏固定及关节融合术等 ;Ⅲ型 2 9例 ,行切开复位或关节融合术等 ;Ⅳ型 4例 ,行切开复位内固定或关节融合术。平均随访 5 18年 ,并依据Hawkin′s评分进行评估。 结果 优 2 2例 (2 4 7% ) ;良 16例 (18 0 % ) ;可 2 8例 (34 8% ) ;差 19例 (2 2 5 % )。其中Ⅱ型以上骨折距骨缺血坏死 4 0 3% (2 5 /6 2 ) ,踝及距下关节创伤性关节炎分别为 2 6 7% (2 3/86 )及4 1 8% (36 /86 ) ,骨折不愈合 7例 8 1%。 结论 Ⅱ型及Ⅲ型骨折应急诊行切开复位内固定术 。
Objective To summarize the experience in treating talar neck fractures. Methods 89 patients with talar neck fracture were followed up, and classified by modified Hawkin′s classification. Three patients of type Ⅰ were treated with plastic cast and K wire, 53 of type Ⅱ with open reduction and internal fixation (ORIF), close reduction and plaster, fusion, and 29 of type Ⅲ and 4 of type Ⅳ with joint fusion and ORIF. Results Mean follow up was 5 18 years. Evaluation by Hawkin′s criteria, showed 22 patients were excellent, 16 good; 28 fair and 19 poor results respectively. Conclusions Emergency operation with ORIF should be performed in type Ⅱ and type Ⅲ talar neck fracture. Medial malleolus osteotomy is recommended when medial approach is used.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2002年第5期366-368,I002,I003,共5页
Chinese Journal of Surgery
