前外侧切口结合距骨定位治疗胫骨远端粉碎性骨折  

Treatment of comminuted distal tibial fractures with anterolateral incision combined with talus localization

作　　者：陈志军[1] 朱东波[1] 杨国涛[1] 周立建[1] CHEN Zhi-jun;ZHU Dong-bo;YANG Guo-tao;ZHOU Li-jian(Dept of Orthopaedics,the People′s Hospital of Danyang City,Danyang,Jiangsu 212300,China)

机构地区：[1]丹阳市人民医院骨科,江苏丹阳212300

出　　处：《临床骨科杂志》2022年第6期877-880,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨前外侧切口结合距骨定位治疗胫骨远端粉碎性骨折的疗效。方法采用前外侧切口结合距骨定位治疗20例胫骨远端粉碎性骨折患者。观察骨折复位情况、骨折愈合时间、踝关节活动度、AOFAS踝-后足功能评分。结果患者均获得随访,时间8~13个月。骨折解剖复位15例,功能复位4例,复位丢失1例。骨折愈合时间3~5个月。末次随访时,踝关节活动度:背伸5°~20°,跖屈20°~45°,均无跟腱挛缩表现;AOFAS踝-后足功能评分69~98分,其中优12例,良6例,可2例,优良率18/20。结论采用前外侧切口结合距骨定位治疗胫骨远端粉碎性骨折具有显露充分、软组织损伤小、复位固定确切、并发症少等优点,有利于患者踝与后足功能恢复。Objective To investigate the effects of anterolateral incision combined with talus localization in the treatment of comminuted distal tibial fractures.Methods The 20 cases of comminuted fracture of distal tibia were treated by anterolateral incision combined with talus localization.Fracture reduction,fracture healing time,ankle range of motion,AOFAS ankle-hindfoot score were observed.Results All patients were followed up for 8~13 months.There were 15 cases of anatomic reduction,4 cases of functional reduction and 1 case of reduction loss.Fracture healing time was 3~5 months.At the last follow-up,the range of motion of ankle joint was dorsal extension with 5°~20°,plantar flexion with 20°~45°,and no achilles tendon contracture was observed.AOFAS ankle-hindfoot scores ranged from 69 points to 98 points,including excellent in 12 cases,good in 6,and fair in 2,the excellent and good rate was 18/20.Conclusions Anterolateral incision combined with talus localization in the treatment of comminuted distal tibial fracture has the advantages of full exposure,less soft tissue injuries,precise reduction and fixation,and fewer complications,which is beneficial to the recovery of ankle-hindfoot function.

关 键 词：前外侧入路 胫骨远端骨折 距骨定位 

分 类 号：R68.42[医药卫生—骨科学] R687.3[医药卫生—外科学]