足舟骨骨折的手术治疗  

Surgical treatment of tarsal navicular fractures

作　　者：俞光荣[1] 夏江[1] 杨云峰[1] 王树青[1] 周家钤[1] 袁锋[1] 黄轶刚[1] 

机构地区：[1]同济大学附属同济医院骨科,上海200065

出　　处：《中华创伤骨科杂志》2010年第8期705-709,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的 探讨不同类型足舟骨骨折的手术治疗方式及临床疗效.方法 2001年5月至2009年4月采用切开复位内固定治疗14例足舟骨骨折患者,男9例,女5例;年龄19～53岁,平均36.5岁.按照骨折部位分类：背侧撕脱骨折2例,舟骨结节撕脱骨折1例,舟骨体骨折11例.舟骨体骨折按照Sangeorzan等提出的分型系统分型：Ⅰ型1例,Ⅱ型 7例,Ⅲ型3例.14例患者根据不同的骨折类型选择螺钉或钢板固定等手术方式治疗.受伤至手术时间为5～20 d,平均11.5 d. 结果 14例患者术后获12～40个月（平均25.6个月）随访.骨折愈合时间为10～15周,平均11.3周.末次随访时按美国足踝外科协会踝与后足评分评定：平均为87.6分（37～100分）.随访过程中末出现内固定断裂及复位丢失.2例患者术后出现不同程度的足舟骨缺血性坏死合并距舟关节创伤性关节炎,其中1例患者足舟骨塌陷较严重,并累及后足,二期行三关节融合术. 结论 足舟骨骨折根据不同的骨折类型,采用合理的术式和恰当的内固定可以取得较好的疗效.Objective To discuss operative methods and effects for different types of tarsal navicular fractures. Methods Fourteen patients with tarsal navicular fractures were treated in our department from May 2001 to April 2009. There were 9 males and 5 females, with an average age of 36.5 years （range, 19 to 53 years）. According to the conventional fracture classification, 2 of them had dorsal avulsion fractures, one tuberosity avulsion fracture and the other 11 body fractures. The body fractures were further classified by the Sangeorzan system： one type Ⅰ, 7 type Ⅱ and 3 type Ⅲ. Different surgical treatments were selected for different types of the fracture. Results All the patients were followed up for 25.6 months on average （range, 12 to 40 months）. The mean time of bone union was 11.3 weeks （range, 10 to 15 weeks）. By the Ankle and Hindfoot score system of American Orthopaedic Foot and Ankle Society （AOFAS）, the mean score was 87.6（ranging from 37 to 100）at the last follow-up. Conclusion To achieve satisfactory outcomes for tarsal navicular fractures, a reasonable surgical procedure and appropriate internal fixation should be chosen according to the specific fracture types.

关 键 词：足 舟骨 骨折 骨折固定术 内 

分 类 号：R686[医药卫生—骨科学]