钢板联合经皮克氏针固定Chopart关节骨折脱位  

Plate internal fixation combined with percutaneous Kirschner wire fixation for Chopart fracture and dislocation

作　　者：汪海清[1] 姚陆丰[1] 申成春[1] 张峰[1] 朱大东 俞嘉培 黄雷[1] WANG Hai-qing;YAO Lu-feng;SHEN Cheng-chun;ZHANG Feng;ZHU Da-dong;YU Jia-pei;HUANG Lei(Department of Foot and Ankle Surgery,Ningbo Sixth Hospital,Ningbo,Zhejiang 315040,China;Department of Foot and Ankle Surgery,Ningbo Fenghua Xinqiao Orthopaedic Hospital,Ningbo,Zhejiang 315500,China)

机构地区：[1]宁波市第六医院足踝外科,浙江宁波315040 [2]宁波市奉化新桥骨科医院足踝外科,浙江宁波315500

出　　处：《中国矫形外科杂志》2025年第4期356-360,共5页Orthopedic Journal of China

基　　金：浙江省医药卫生项目(编号:2024KY385);宁波市卫生健康科技计划项目(编号:2023Y64);宁波市鄞州区科技项目(编号:2021AS0068、2020AS073);宁波市奉化区科技项目(编号:202106415)。

摘　　要：[目的]评价钢板内固定联合经皮克氏针固定Chopart关节骨折脱位的临床疗效。[方法]回顾性分析2019年1月—2022年12月在本院收治的Chopart关节骨折脱位13例患者的临床资料,均采用开放复位钢板内固定联合经皮克氏针固定的治疗方式。评价临床及影像学结果。[结果]所有患者均顺利完成手术,无重要神经、血管损伤等并发症。随访时间平均(20.0±5.4)个月。末次随访AOFAS中足评分平均(83.2±6.7)分,Karlsson-Peterson评分平均(78.2±7.1)分。与术前相比,末次随访VAS评分显著减少[(8.0±0.7),(2.5±1.4),P<0.001]。影像方面,与术前相比,末次随访时患足负重侧位X线片Meary角[(15.2±3.2)°,(3.2±2.4)°,P<0.001]和侧位台阶征位移距离(step-off sign,SOS)[(9.0±2.1)mm,(1.0±0.8)mm,P<0.001]均显著减小。[结论]钢板内固定联合经皮克氏针固定Chopart关节骨折脱位手术安全,临床结果满意。[Objective]To evaluate the clinical efficacy of plate internal fixation combined with percutaneous Kirschner wire fixation for Chopart fracture and dislocation.[Methods]A retrospective study was conducted on 13 patients who had Chopart fracture and dislocation treated by open reduction and plate internal fixation combined with percutaneous Kirschner wire fixation in our hospital from January 2019 to December 2022.The clinical and imaging documents were evaluated.[Results]All the 13 patients had operation performed successfully without important nerve,vascular injury and other complications,and followed up for(20.0±5.4)months in an average.The AOFAS score was of(83.2±6.7),while the Karlson-Peterson score was of(78.2±7.1)on average.Compared with that preoperatively,the VAS score significantly reduced at the latest follow up[(8.0±0.7),(2.5±1.4),P<0.001].As for Imaging,the Meary Angle[(15.2±3.2)°,(3.2±2.4)°,P<0.001]and step-off sign(SOS)[(9.0±2.1)mm,(1.0±0.8)mm,P<0.001]on the lateral X-rays with weight bearing significantly reduced at the last follow-up compared with those before operation.[Conclusion]Plate internal fixation combined with percutaneous Kirschner wire fixation is safe and satisfactory regarding clinical consequence for Chopart fracture and dislocation.

关 键 词：中跗关节(Chopart关节) 骨折脱位 开放复位内固定 经皮克氏针固定 

分 类 号：R683.42[医药卫生—骨科学]