[1]苏攀,赵鹏,穆世民,等.Gatellier-Chastang后外侧入路治疗合并Die-punch骨块的后踝骨折[J].中医正骨,2019,31(05):55-58.
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Gatellier-Chastang后外侧入路治疗合并Die-punch骨块的后踝骨折()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期数:
2019年05期
页码:
55-58
栏目:
临床报道
出版日期:
2019-05-20

文章信息/Info

作者:
苏攀; 赵鹏; 穆世民; 娄磊
(河南省洛阳正骨医院/河南省骨科医院,河南 洛阳 471002)
关键词:
踝关节;  关节内骨折;  骨折固定术
摘要:
目的:探讨Gatellier-Chastang后外侧入路治疗合并Die-punch骨块的后踝骨折的临床疗效。方法:2016年3月至2018年2月,采用Gatellier-Chastang后外侧入路治疗合并Die-punch骨块的后踝骨折患者23例,男9例、女14例; 年龄24～71岁,中位数50岁。合并外踝骨折4例,合并外踝骨折、下胫腓联合损伤2例,合并内、外踝骨折及踝关节半脱位10例,合并内、外踝骨折及踝关节半脱位、下胫腓联合损伤4例,合并外踝骨折、三角韧带损伤、踝关节半脱位2例,合并外踝骨折、三角韧带损伤、踝关节半脱位、下胫腓联合损伤1例。受伤至手术时间5～22 d,中位数9 d。术中先复位Die-punch骨块,对合关节面平整后再复位固定后踝骨折。术后1周,在X线片上采用Burwell-Charnley影像学评估标准(1965)对骨折复位情况进行评价。观察骨折愈合情况,采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足功能评分标准评价踝关节功能。结果:本组23例均顺利完成手术。术后1周依据上述评价标准,本组解剖复位19例、复位可3例、复位差1例。骨折复位可的3例,关节面挫伤、软骨剥脱,关节面骨质有缺损; 骨折复位差的1例,关节面出现约0.5 cm的台阶。患者均获随访,随访时间12～19个月,中位数16个月。骨折均愈合,愈合时间9～22周,中位数14周。末次随访时,本组踝关节AOFAS评分(82.70±14.76)分,优15例、良5例、可3例。结论:Gatellier-Chastang后外侧入路治疗合并Die-punch骨块的后踝骨折,骨折复位、愈合好,有利于踝关节功能恢复。

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更新日期/Last Update: 2019-05-20