[1]何永志,陈志达△,张哲明,等.后内侧联合后外侧入路治疗外踝后踝骨折[J].中国中医骨伤科杂志,2023,31(06):66-70.[doi:10.20085/j.cnki.issn1005-0205.230612]
　HE Yongzhi,CHEN Zhida,ZHANG Zheming,et al.Posteromedial Combined with Posterolateral Approach on the Treatment of Haraguchi Type Ⅱ and Ⅲ Fractures of the Lateral Malleolus and Posterior Malleolus[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(06):66-70.[doi:10.20085/j.cnki.issn1005-0205.230612]
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后内侧联合后外侧入路治疗外踝后踝骨折()
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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06期
页码:
66-70
栏目:
临床报道
出版日期:
2023-06-15

文章信息/Info

Title:
Posteromedial Combined with Posterolateral Approach on the Treatment of Haraguchi Type Ⅱ and Ⅲ Fractures of the Lateral Malleolus and Posterior Malleolus
文章编号:
1005-0205(2023)06-0066-05
作者:
何永志1; 陈志达1△; 张哲明1; 蔡弢艺1; 张剑平1
1联勤保障部队第九〇九医院(厦门大学附属东南医院)全军骨科中心(福建 漳州,363000)
Author(s):
HE Yongzhi1; CHEN Zhida1△; ZHANG Zheming1; CAI Taoyi1; ZHANG Jianping1
1Orthopaedic Center of People's Liberation Army,The 909th Hospital of Joint Logistic Support Force(Dongnan Hospital of Xiamen University),Zhangzhou 363000,Fujian China.
关键词:
踝关节骨折;  后踝;  外踝;  微型钢板
Keywords:
ankle joint fracture;  posterior malleolus;  external malleolus;  mini-plate
分类号:
R683.42
DOI:
10.20085/j.cnki.issn1005-0205.230612
文献标志码:
B
摘要:
目的:探讨后内侧联合后外侧入路治疗外踝、后踝HaraguchiⅡ、Ⅲ型骨折的临床疗效。方法:对2017年1月至2021年1月52例伴有外踝、后踝HaraguchiⅡ、Ⅲ型的踝关节骨折患者,通过俯卧位后内侧联合后外侧入路进行复位外踝钢板固定、后踝微型钢板或中空螺钉固定。其中男37例,女15例,平均年龄为(38.3±14.9)岁。收集患者手术时间、出血量、骨折愈合时间及并发症发生情况,并根据Baird-Jackson踝关节功能评分评估疗效。结果:本组患者平均手术时间为(105.7±28.4)min,平均出血量为(68.4±18.7)mL。关节面复位台阶均小于2 mm,所有患者均获得随访,时间为14～23个月,平均为(16.4±4.7)个月,骨折愈合时间为(3.2±1.7)个月,末次随访时Baird-Jackson踝关节功能平均评分为(93.5±3.7)分。其中优44例,良8例,优良率为100%。本组患者均未出现皮肤坏死、切口感染及内固定失败等并发症。结论:后内侧联合后外侧入路治疗外踝、后踝HaraguchiⅡ、Ⅲ型骨折疗效满意,直视下同时显露、复位与固定后踝骨块,并发症少。
Abstract:
Objective:To investigate the clinical efficacy of posteromedial combined with posterolateral approach on the treatment of lateral and posterior malleolus fracture of Haraguchi type Ⅱ and Ⅲ.Methods:From January 2017 to January 2021,52 patients of ankle fractures with lateral malleolus and posterior Haraguchi type Ⅱ and Ⅲ were treated by reduction and fixation with lateral malleolus plate,posterior malleolus mini-plate or hollow screw through posteromedial combined posterolateral approach in prone position.There were 37 males and 15 females,with an average age of(38.3±14.9)years old.And the operative time,intraoperative bleeding,fracture healing time and complications were recorded.Clinical efficacy was evaluated according to Baird-Jackson ankle function score.Results:The average operation time was(105.7±28.4)min,and the average blood loss was(68.4±18.7)mL.The articular surface reduction steps were less than 2 mm.All patients were followed up for 14 to 23(16.4±4.7)months.Fracture healing time was(3.2±1.7)months,and the average score of Baird-Jackson ankle function was(93.5±3.7)points at the last follow-up,of which 44 cases were excellent and 8 cases were good,with an excellent rate of 100%.There were no complications such as skin necrosis,incision infection,and internal fixation failure in this group.Conclusion:The posteromedial combined with posterolateral approach has satisfactory efficacy on the treatment of lateral malleolus and posterior ankle Haraguchi type Ⅱ and Ⅲ fractures,and the posterior ankle bone is simultaneously exposed,reduced and fixed under direct vision,with few complications.

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备注/Memo

备注/Memo:
基金项目:漳州市自然科学基金项目(ZZ2018J10)
全军军事训练伤防治研究专项(21XLS23)
△通信作者 E-mail:czd5320@163.com
更新日期/Last Update: 2023-06-10