天津医药

• 临床论丛 • 上一篇    下一篇

距骨体剪力骨折的手术治疗分析

梁双   

  1. 天津市宝坻区人民医院
  • 收稿日期:2011-02-28 修回日期:2011-07-11 出版日期:2011-10-15 发布日期:2011-10-15
  • 通讯作者: 梁双

  • Received:2011-02-28 Revised:2011-07-11 Published:2011-10-15 Online:2011-10-15

PDF (PC)

1958

摘要： 摘要：目的：探讨距骨体剪力骨折的治疗方法和临床疗效。方法:自2007年2月至2009年1月采用经内踝截骨或结合外踝前外侧手术入路治疗15例距骨体剪力骨折，按Boyd和Knight剪力骨折分型：I型共13例，其中IB8例，IC型3例，ID型2例；ⅡB型2例。闭合性骨折10例，开放性5例(均为Gustilo-AndersonⅡ型)。距骨体骨折合并踝部骨折4例；距骨体骨折合并距骨颈骨折1例。结果：本组病例15例全部获得随访，随访时间19-46个月，平均28.6个月。术后伤口浅表感染3例，伤口皮缘坏死2例。距骨缺血性坏死5例。无骨折不愈合病例。结果按Hawkins疗效标准评定评价：优6例；良5例；可2例；差2例。优良率为73.3%。结论：距骨体剪力骨折应早期解剖复位坚强内固定，以降低距骨缺血性坏死和创伤性关节炎的发生率。距骨体开放骨折或合并距骨颈骨折明显影响其预后。

关键词: 距骨, 骨折, 骨折固定术, 并发症

Abstract: Abstract Objective To investigate the treatment method and clinical curative effection of the talar body shear fractures.Method From Februray 2007 to January 2009 through medial malleolar osteotomy approach or combine with anterior-lateral approach we treated 15 patients of talar body shear fracture, According to Boyd and Knight classification system: 8 cases were typeIB;3 cases were ICtype;2 cases were IDtype and 2 cases wereⅡBtype.Five of fifteen fractures were Gustilo-Anderson type Ⅱ open fracture..Four patients had a concomitant malleolarfractures and one patient had a concomitant talar neck fracture.Result All of 15 patients were followed up from 19 to 46 months with an average of 28.6 months.Early complications included three superficial wound infections,two instance of skin necrosis. Talar body avascular necrosis in five and no talar body fracture ununion.According to Hawkins criteria standard，the results were excellent function in six patients, good in five, fair in two and poor in two.The excellent and good rate was 73.3%.Conclusion Talar body shear fractures should early be accurate reduction and stable fixation in order to reduce the complication of talar body avascular necrosis and posttraumatic arthritis.Talar body fracture associated with open injuries or talar neck fractures are associated with a less favourable outcome.

Key words: Talus, Fracture, Fracture fixation, Complication