空心钉与克氏针置入修复跖跗关节骨折脱位:解剖复位及足踝功能评估  

Cannulated screw and Kirschner wire fixation for fracture dislocation of tarsometatarsal joint:anatomic reduction and ankle functional assessment

作　　者：杨兆先 赵汉平 

机构地区：[1]山东省阳谷县中医院骨外科,山东省阳谷县252300 [2]解放军八十八医院骨科中心,山东省泰安市271000

出　　处：《中国组织工程研究》2015年第31期5026-5030,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:在跖跗关节骨折脱位以往的临床治疗过程中,采取的大多是闭合复位外固定的方式,但往往无法获得满意的修复效果,患者局部肿胀消退之后容易出现再移位的情况。因此,临床开始积极的利用切开复位内固定的方式对跖跗关节骨折脱位患者进行治疗,以恢复患足部功能,提高生活质量。目的:探讨跖跗关节骨折脱位行切开复位空心钉与克氏针置入内固定的临床效果。方法:从解放军八十八医院2012年9月至2013年9月收治的跖跗关节骨折脱位患者中随机选择42例进行研究,均实施切开复位空心钉与克氏针置入内固定治疗。治疗后随访患者的恢复情况,并利用美国足踝外科学会踝-后足评分量表对患者的踝-后足功能进行评定。结果与结论:入组的42例患者均获随访,随访时间1-12个月。经随访美国足踝外科学会踝-后足评分达到"好"的有30例,达到"较好"的有10例,评分为"差"的有2例,且此2例患者为受高能量损伤软组织情况较差者。37例患者在治疗后4-6个月即开始负重行走;3例患者存在轻微疼痛,以及一定的功能受限情况,可维持基本正常的行走步态;其余2例患者并发创伤性关节炎,无法正常负重行走。表明跖跗关节骨折脱位行切开复位空心钉与克氏针置入内固定可以达到良好的解剖复位效果,改善患者的足踝功能。BACKGROUND：Closed reduction and internal fixation are mostly used to treat fracture dislocation of tarsometatarsal joint, but cannot obtain satisfactory repair effect. Redisplacement easily appeared after local sweling subsidence. Therefore, open reduction and internal fixation are actively used in the clinic to treat fracture dislocation of tarsometatarsal joint so as to restore foot function and to elevate quality of life. OBJECTIVE：To explore the clinical effect of open reduction and cannulated screw and Kirschner wire fixation for fracture dislocation of tarsometatarsal joint. METHODS：A total of 42 patients with fracture dislocation of tarsometatarsal joint in the 88 Hospital of Chinese PLA from September 2012 to September 2013 were selected and were given open reduction and cannulated screw and Kirschner wire fixation. After treatment, the recovery of patients was observed, and ankle hindfoot function was assessed with American Orthopaedic Foot and Ankle Society ankle hindfoot score.nbsp;RESULTS AND CONCLUSION：A total of 42 patients were folowed up for 1-12 months. American Orthopaedic Foot and Ankle Society ankle hindfoot score results showed that there were excelent in 30 cases, good in 10 cases, and poor in 2 cases, and the 2 patients were subjected to high energy soft tissue injury. 37 patients in 4-6 months after operation started weight-bearing walking. Three patients had mild pain, a certain functional limitation, but could maintain normal walking gait. The remaining two patients complicated with traumatic arthritis, and were unable to do normal weight-bearing walking. These results show that open reduction and cannulated screw and Kirschner wire fixation can achieve good effect of anatomical reduction of fracture dislocation of tarsometatarsal joint, and improve patient’s ankle function.

关 键 词：植入物 骨植入物 跖跗关节 骨折 脱位 切开复位内固定 空心钉 克氏针 

分 类 号：R318[医药卫生—生物医学工程]