经踝后内侧入路Herbert螺钉内固定治疗距骨后突骨折22例  

Herbert screw for the treatment of talus posterior process fracture

作　　者：孙志波[1] 禹志宏[1] 刘斌[1] 孙晨[1] 杨述华[2] 

机构地区：[1]湖北医药学院附属人民医院创伤骨科,湖北十堰442000 [2]华中科技大学同济医学院附属协和医院骨科,湖北武汉430030

出　　处：《生物骨科材料与临床研究》2015年第4期26-28,共3页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的 探讨经踝后内侧入路Herbert螺钉内固定治疗距骨后突骨折的临床疗效.方法 对2010年6月～2013年5月术治疗的22例距骨后突骨折患者的治疗效果进行总结分析.术前常规行三维CT扫描明确骨折类型及移位情况,采用经踝后内侧入路Herbert螺钉内固定,术后早期不负重功能锻炼.根据美国足踝外科协会（AOFAS）踝与后足评分标准进行功能评价.结果 22例患者距骨后突骨折均获满意复位,其中19例患者术后得到10～22个月随访,平均16.6个月,均达到骨性愈合.AOFAS评分58～92分,平均83.12分,其中优8例,良8例,可2例,差1例;优良率为84％（16/19）.结论 经踝后内测入路Herbert螺钉内固定治疗距骨后突骨折可有效恢复距骨解剖结构及关节面平整,结合早期不负重功能锻炼可获得较好的临床效果.Objective To investigate the clinical effectiveness of Herbert screw for the treatment of talus posterior process fracture through a postermedial approach. Methods The therapeutic effects of 22 patients with talus posterior process fracture from June 2010 to May 2013 were summarized and analyzed. Conventional pre-operative three-dimensional CT scans were used to Clear fracture type and displacement, through a posteromedial approach and Herbert screw internal fixation. Early functional exercise not weight-bearing postoperatively. According to the hindfoot score system of American Orthopaedic Foot and Ankle Society （AOFAS） for functional evaluation criteria. Results All 22 patients obtained sound reduction, of whom 19 patients had bony union after 10 to 22 months follow-up post-operatively （median follow-up period, 16.6months）, The AOFAS was 83.12 （range, 58 to 92）, with 8 excellent cases, 8 good cases, 2 fair cases and 1 poor case; the excellent and good rate was 86 % （16/19）. Conclusion Herbert screw for the treatment of talus posterior process fracture through a postermedial approach can effectively restore the alignment and joint surface oftalus, combined with early non weight bearing exercise can obtain good clinical effectiveness.

关 键 词：HERBERT螺钉 骨折固定术 内 距骨 

分 类 号：R687.3[医药卫生—骨科学]