经内踝截骨入路微型钢板固定治疗Hawkins Ⅲ型距骨颈骨折  被引量:5

Operative Treatment of Hawkins Type Ⅲ Talar Neck Fracture through Medial Malleolar Osteotomy Approach and Mini-plate Fixation

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作  者:陈志达[1] 吴进[1] 林斌[1] 曾文容[1] 刘晖[1] 

机构地区:[1]厦门大学附属东南医院骨科全军骨科中心,福建漳州363000

出  处:《实用骨科杂志》2016年第9期799-801,共3页Journal of Practical Orthopaedics

摘  要:目的探讨经内踝截骨入路微型钢板固定治疗Hawkins Ⅲ型距骨颈骨折的手术方法及疗效。方法 2008年1月至2014年3月,我们对14例Hawkins Ⅲ型距骨颈骨折的患者行经内踝截骨的前内侧入路切开复位微型钢板内固定术治疗,根据患者主诉、后跟及踝关节外形、功能及X线片征象来评价临床疗效。结果本组14例病例均获得随访18~41个月,平均随访29.6个月。末次随访时患者的平均AOFAS踝与后足评分为(79.8±17.3)分,按其疗效标准进行评价,优6例(42.9%),良3例(21.4%),可4例(28.6%),差1例(7.1%),优良率64.3%。3例患者出现不同程度的距骨缺血坏死,6例患者发生创伤性关节炎,累及胫距关节3例,累及距下关节2例,同时累及胫距及距下关节1例。结论经内踝截骨手术入路微型钢板固定治疗Hawkins Ⅲ型距骨颈骨折具有软组织创伤小、对距骨颈显露充分、并发症发生率低、疗效优良等特点。Objective To introduce a surgical treatment of Hawkins type Ⅲ talar neck fracture through medial malleolar osteotomyapproach and mini-plate fixation and discuss the therapeutic effects. Methods From January 2008 to March 2014,15 patients of complex talar body fracture were treated through approach of internal malleolus osteotomy and mini-plate for fixation. The clinical effects was assessed depend on the complaints,functions and radiological results of the ankle and subtalar joint. Results All the patients were followed up 18 t o 41 months with anaverage of 29. 6 months. The average Ankle-Hindfoot score of AOFAS was( 79. 8 ± 17. 3). And according to the score,6 patients were rated as being excellent,3 patient s good,4fair and 1 poor. The total rate of being excellent to good was 64. 3%. Complications occurred at their final follow-up,including three avascular osteonecrosis of talar neck cases,six cases of post-traumatic arthritis. Conclusion Operative treatment of Hawkins type Ⅲ talar neck fracture through medial malleolar osteotomy and mini-plate fixation have the characteristicsof less soft tissue trauma,adequate exposure of talar neck,less incidences of complications,and satisfactory clinical results.

关 键 词:Hawkins Ⅲ型 距骨颈骨折 内踝截骨 微型钢板 

分 类 号:R683.42[医药卫生—骨科学]

 

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