骰骨骨折畸形愈合的手术治疗  

Surgical treatment for malunion of cuboid fractures

作　　者：俞光荣[1] 于涛[1] 朱辉[1] 杨云峰[1] 袁锋[1] 周家钤[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》2012年第6期464-467,共4页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金（30801163）

摘　　要：目的总结骰骨骨折畸形愈合的临床特点，探讨其手术治疗方法。方法2005年10月至2010年9月手术治疗骰骨骨折畸形愈合3例，男2例，女1例；年龄18～71岁，平均40．3岁。均采用外侧柱延长、植骨，桥接钢板或骰骨专用钢板固定。结果3例忠行术后获12～18个月（平均14．3个月）随访，切口均I期愈合。骨折愈合时让为9～14周，平均10．7周。患者术后平均12．7周（9～17周）时可完令负重行走，尤明显疼痛和小适。采用美国足踝外科协会（AOFAS）中足评分标准，术前评分为49～54分，平均51．3分；术后随访评分为73～85分，平均81．0分。结论对于有明显症状而保守治疗无效的骰骨骨折畸形愈合，外侧柱长度的重建利维持是治疗的关键。Objective To discuss operative treatments for the malunion of cuboid fractures.our department. They were 2 males and one female with an average age of 40. 3 years （from 18 to 71 years）. The surgical treatments included extension of the lateral column, bone grafting, internal fixation with a bridging or special euboid plale. The American Orthopaedic Foot ＆ Ankle Sociely （AOFAS） system was used for functional evaluation. Results All the 3 patients were followed up for 14.3 months on average （from 12 to 18 months）. All incisions healed primarily, and all fractures uniled after a mean time of 10. 7 weeks （from 9 to 14 weeks）. No infection was found in the 3 eases. They achieved full-welght-loading walking after a mean time of 12.7 weeks （from 9 to 17 weeks）. According to the AOFAS midfoot scale, their preoperative mean score of 51.3 （from 49 to 54） was improved to 81.0 （from 73 to 85） at the last postoperative follow-ups. Conclusion In the treatment of malumion of cuboid fracture, it is critical for those who have obvious symptoms and do not respond to conservative management to restore and maintain the length of the lateral column.

关 键 词：足 骨折 内固定 随访研究 畸形愈合 

分 类 号：R687.3[医药卫生—骨科学]