[1]胡鹏,魏志勇,余福钦,等.踝关节内侧脱位入路治疗踝关节骨折伴有后踝塌陷骨块16例[J].中国中医骨伤科杂志,2023,31(01):73-76.
　HU Peng,WEI Zhiyong,YU Fuqin,et al.16 Cases of Clinical Report on Ankle Medial Dislocation Approach on the Treatment of Patients with Posterior Ankle Depressed Fragments[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(01):73-76.
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踝关节内侧脱位入路治疗踝关节骨折伴有后踝塌陷骨块16例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年01期
页码:
73-76
栏目:
临床报道
出版日期:
2023-01-15

文章信息/Info

Title:
16 Cases of Clinical Report on Ankle Medial Dislocation Approach on the Treatment of Patients with Posterior Ankle Depressed Fragments
文章编号:
1005-0205(2023)01-0073-04
作者:
胡鹏1; 魏志勇1; 余福钦1; 陈王1; 余添赐1; 郑琼红1; 李铭雄1△
1泉州市正骨医院下肢二科(福建 泉州,362000)
Author(s):
HU Peng1; WEI Zhiyong1; YU Fuqin1; CHEN Wang1; YU Tianci1; ZHENG Qionghong1; LI Mingxiong1△
1Department of Limb,Orthopedic Hospital of Quanzhou City,Quanzhou 362000,Fujian China.
关键词:
后踝骨折;  塌陷骨块;  踝关节内侧脱位;  入路
Keywords:
posterior fractures;  depressed fragments;  ankle medial dislocation;  approach
分类号:
R683.42
文献标志码:
B
摘要:
目的:探讨踝关节内侧脱位入路治疗踝关节骨折伴有后踝塌陷骨块的安全性及临床疗效。方法:回顾性分析2016年3月至2021年1月收治且获得随访的16例旋后外旋型4度踝关节骨折患者资料,均采用踝关节内侧脱位入路处理后踝塌陷骨块。观察术后骨折的复位,伤口愈合,是否存在距骨或者胫骨远端缺血性骨坏死等情况。踝关节功能评估采用美国足踝外科协会踝-后足评分。结果:患者均获得随访,随访时间为8～12个月,平均为(9.8±1.5)个月。骨折复位良好,未发现伤口并发症、距骨或者胫骨远端缺血性骨坏死等情况。骨折愈合时间为2～4个月,平均为(2.8±0.6)个月,未出现内固定失效。踝关节功能良好,踝关节AOFAS评分为82～96分,平均为(92.6±4.9)分。结论:踝关节内侧脱位入路治疗踝关节骨折伴有后踝塌陷骨块暴露充分,操作简单,无明显并发症,临床效果满意。
Abstract:
Objective:To explore the clinical safety and efficacy of ankle medial dislocation approach on the treatment of patients with posterior ankle depressed fragments.Methods:Data of 16 patients with 4 degree ankle fracture of supination external rotation,were analyzed retrospectively.These patients were admitted and followed up ranging from March 2016 to January 2021.They were all adopted ankle medial dislocation approach to deal with posterior ankle depressed fragments.The quality of fractures reduction,incision healing and incidence of talus and distal tibia necrosis and other parameters were observed.The ankle function was assessed using the American Association of Foot and Ankle Surgery(AOFAS )Ankle-Posterior Foot score.Results:All patients were followed up for 8 to 12 months,with(9.8±1.5)months on average. Fracture reduction was satisfactory without wound complications,avascular osteonecrosis of talus or distal tibia.The fracture healing time ranged from 2 to 4 months,average(2.8±0.6)months,without failure of internal fixation.The ankle joint function was good,and the ankle score was 82 to 96 points with an average of(92.6±4.9)points.Conclusion:Ankle medial dislocation approach on the treatment of posterior ankle depressed fragments has the advantages of full exposure and simple operation,and there are no obvious complications and satisfactory clinical efficacy.

参考文献/References:

[1] TEJWANI N C,PAHK B,EGOL K A.Effect of posterior malleolus fracture on outcome after unstable ankle fracture[J].J Trauma,2010,69(3):666-669.
[2] AMOROSA L F,BROWN G D,GREISBERG J.A surgical approach to posterior pilon fractures[J].J Orthop Trauma,2010,24(3):188-193.
[3] BARTONÍCˇEK J,RAMMELT S,KOSTLIVÝ K,et al.Anatomy and classification of the posterior tibial fragment in ankle fractures[J].Arch Orthop Trauma Surg,2015,135(4):506-516.
[4] SULTAN F,ZHENG X D,PAN Z J,et al.Characteristics of intercalary fragment in posterior malleolus fractures[J].Foot Ankle Surg,2020,26(3):289-294.
[5] RAMMELT S,BARTONÍEK J.Posterior malleolar fractures:a critical analysis review[J].JBJS Rev,2020,8(8):e19.00207.
[6] WEBER M.Trimalleolar fractures with impaction of the posteromedial tibial plafond:implications for talar stability[J].Foot Ankle Int,2004,25(10):716-727.
[7] BARTONÍCˇEK J,RAMMELT S,TUCˇEK M.Posterior malleolar fractures:changing concepts and recent developments[J].Foot Ankle Clin,2017,22(1):125-145.
[8] MYERS D M,KELLEY J A,TAYLOR B C,et al.The intercalary fragment in posterior malleolus fractures:characterization and significance[J].J Foot Ankle Surg,2022,61(5):1060-1064.
[9] 冯彦江,杨生民,李西要,等.部分切断下胫腓后韧带浅层辅助复位治疗旋后外旋型踝关节骨折中合并塌陷骨块的后踝骨折[J].中医正骨,2020,32(8):65-68.
[10] KIM M B,LEE Y H,KIM J H,et al.Lateral transmalleolar approach and miniscrews fixation for displaced posterolateral fragments of posterior malleolus fractures in adults:a consecutive study[J].J Orthop Trauma,2015,29(2):105-109.
[11] 刘波,乔之军,曹光华,等.后内侧胫后肌腱前方入路联合后外侧入路切开复位内固定治疗Klammer Ⅱ/Ⅲ型后Pilon样骨折[J].中华创伤杂志,2021,37(12):1099-1104.
[12] BLANKE F,LOEW S,FERRAT P,et al.Osteonecrosis of distal tibia in open dislocation fractures of the ankle[J].Injury,2014,45(10):1659-1663.
[13] BALDASSARRE R L,PATHRIA M N,HUANG B K,et al.Periosteal stripping in high ankle sprains:an association with osteonecrosis[J].Clin Imaging,2020,67:237-245.

备注/Memo

备注/Memo:
△通信作者 E-mail:381460662@qq.com
更新日期/Last Update: 2023-01-10