支撑钢板结合双头加压螺钉治疗旋后内收型Ⅱ度踝关节骨折的效果  

Efficacy of buttress plate combined with double-headed compression screw for fixation of supination-adduction type-Ⅱmedial malleolar fractures

作　　者：张兴州[1] 徐鹏[1] 李冰[1] 何樟宁 袁亚兵[1] 钱志鹏 刘延辉[1] ZHANG Xingzhou;XU Peng;LI Bing(Department of Foot and Ankle Surgery.Affiliated Hospital of Wujin,Nanjing University of Traditional Chinese Medicine,Changzhou 213161,CHINA)

机构地区：[1]常州市武进中医医院(南京中医药大学武进附属医院)足踝外科,江苏213161

出　　处：《江苏医药》2021年第11期1148-1150,共3页Jiangsu Medical Journal

摘　　要：目的观察支撑钢板结合双头加压螺钉治疗旋后内收型Ⅱ度踝关节骨折的效果。方法旋后内收型Ⅱ度踝关节骨折患者38例采用1~2枚双头加压螺钉结合支撑钢板对内踝骨折块进行内固定。术后复查X射线片评估骨折复位及愈合情况。记录患者术后完全负重时间。采用美国矫形足踝协会(AOFAS)踝与后足评分标准评估疗效。观察相关并发症发生情况。结果 34例患者获得10~38个月术后随访。AOFAS评分为(85.3±9.0)分。术后完全负重时间为(11.3±1.8)周。X射线片复查显示,34例患者全部获得解剖复位并骨性愈合,3例(8.3%)发生创伤性关节炎。无翻修病例。结论采用支撑钢板结合双头加压螺钉行旋后内收型Ⅱ度踝关节骨折内固定可有效对抗内踝骨折块的垂直剪切力,提高踝关节稳定性,利于术后早期负重锻炼。Objective To observe the clinical efficacy of buttress plate combined with double-headed compression screw for the internal fixation of supination-adduction type-Ⅱmedial malleolar fractures.Methods The internal fixation of supination-adduction type-Ⅱmedial malleolar fractures with one to two buttress plate combined double-headed compression screws was performed in 38 cases.Postoperative anteroposterior and lateral X-ray films were taken to evaluate fracture reduction and union condition.The American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score was used to evaluate the treatment efficacy.The full weight-bearing time and relevant complications were recorded.Results Thirty-four patients were followed up postoperatively for 10 to 38 months, which showed that anatomic reduction and bony union were observed in all the patients with the AOFAS score of(85.3±9.0) points.The full weight-bearing time was(11.3±1.8) weeks.Three(8.3%) patients developed traumatic ankle arthritis.No case needed reoperation.ConclusionThe internal fixation of supination-adduction type-Ⅱmedial malleolar fractures with buttress plate combined with double-headed compression screw can effectively resist the vertical shear force of the medial malleolus fracture block and improve the stability of the ankle joint, which benefits the early weight-bearing exercise after operation.

关 键 词：踝关节骨折 支撑钢板 双头加压螺钉 

分 类 号：R683[医药卫生—骨科学]