手术治疗青少年Tillaux-Chaput骨折合并后踝骨折疗效分析  

Surgical treatment of juvenile Tillaux-Chaput fracture combined with posterior malleolus fracture

作　　者：张雷[1] 侯念宗[1] 

机构地区：[1]淄博市中心医院骨外科,255000

出　　处：《国际骨科学杂志》2017年第3期197-199,共3页International Journal of Orthopaedics

摘　　要：目的探讨切开复位内固定治疗青少年Tillaux-Chaput骨折合并后踝骨折的临床效果。方法回顾性分析2010年6月至2015年1月11例采用切开复位内固定治疗并获得随访的青少年Tillaux-Chaput骨折合并后踝骨折患者资料,其中男7例,女4例,年龄12~17岁,平均(14.2±1.2)岁。所有患者均采用后外侧入路复位后踝骨折,用1~2枚空心螺钉固定于胫骨前结节,复位Tillaux-Chaput骨折后用1~2枚克氏针固定。术后定期复查,记录骨折愈合时间及并发症,根据美国足踝外科协会(AOFAS)踝-后足评分标准评价踝关节功能。结果术后随访8~15个月,平均13个月,所有骨折均骨性愈合,愈合时间为6~12周,平均8周。无骨折块移位、骨骺损伤、内固定松动断裂、排异反应、踝关节活动受限、负重行走疼痛不适等并发症发生。末次随访时所有患者均行走正常,AOFAS踝-后足评分90~98分,平均95.4分。结论切开复位内固定是治疗青少年Tillaux-Chaput骨折合并后踝骨折的有效方法。Objective To explore the clinical outcome of open reduction and internal fixation of juvenile Tillaux-Chaput fracture combined with posterior malleolar fracture. Methods Eleven juvenile patients with Tillaux-Chaput fracture combined with posterior malleolar fracturewere treated with anatomic reduction and internal fixation hrom June 2010 to January 2015. The patients consisted of 7 boys and 4 average age of 14. 2 years （range,12-17 years）. The posterior malleolus fractures were reduced through the posterwith 1 or 2 cannulated screws. The Tillaux-Chaput fractures were reduced through the anterolateral approach and fixed with 1 or 2 Kirschner wires. All patients were assessed with the ankle and hind.foot clinical rating system of the （AOFAS）. Results All patients were followed up for 8-150 months （average 13 months）. The fracture healed 6-12 weeks,with an average of8 weeks. No complications were recorded,such as fracture re-displacement,epiphyseal injury,fixation k）〇 sening,rejection of implants？ limitedrange of motion of the ankle joints？ pain or discomfort during weight-bearing walking and so on. The average AOFAS score postoperatively was 95. 4 points （range,90-98 points）,and all patients had a normal walking gait. Conclusion Open reduction and internal fixation is an effectivemethod for the treatment of juvenile Tillaux-Chaput fracture combined with posterior malleolar fracture.

关 键 词：青少年 后踝骨折 Tillaux-Chaput骨折 内固定 

分 类 号：R726.8[医药卫生—儿科]