[1]杜俊锋,陈卫东,梁林,等.全踝关节镜下复位经皮内固定治疗Maisonneuve骨折[J].中医正骨,2024,36(06):70-74.
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全踝关节镜下复位经皮内固定治疗Maisonneuve骨折()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期数:
2024年06期
页码:
70-74
栏目:
临床报道
出版日期:
2024-06-20

文章信息/Info

作者:
杜俊锋; 陈卫东; 梁林; 余春华; 朱仰义
绍兴市上虞人民医院,浙江 绍兴 312300
关键词:
踝部骨折;  Maisonneuve骨折;  关节镜检查;  经皮内固定术
摘要:
目的:探讨全踝关节镜下复位经皮内固定治疗Maisonneuve骨折的临床疗效和安全性。方法:2020年1月至2023年1月收治12例Maisonneuve骨折患者。男8例,女4例; 年龄21～54岁,中位数38岁; 扭伤8例,高处坠落伤2例,车祸伤2例; 所有患者均为闭合性损伤,左侧5例、右侧7例; Lauge-Hansen分型均为旋前外旋型Ⅳ度; 受伤至手术时间3～10 d,中位数4 d。所有患者均采用全踝关节镜下复位经皮内固定治疗。采用视觉模拟量表(visual analogue scale,VAS)评价踝关节疼痛程度,采用美国足与踝关节协会(American Orthopedic Foot and Ankle Society,AOFAS)踝与后足评分标准评价踝关节功能,观察记录治疗及随访期间并发症的发生情况。结果:12例患者均顺利完成手术,手术时间60～120 min,中位数84 min。术中未发生神经、血管、肌腱损伤。关节镜下检出合并距骨软骨损伤8例,距腓前韧带损伤2例,踝关节游离体2例。所有患者均获随访,随访时间12～16个月,中位数14个月。切口均甲级愈合,所有患者术后6周时均能完全负重行走,所有骨折均在3个月内获得骨性愈合。2例患者在康复训练时出现跟腱疼痛,经药物和物理治疗后缓解。踝关节疼痛VAS评分,术前(6.12±1.06)分、末次随访时(0.33±0.20)分; 末次随访时AOFAS踝与后足评分(94.1±2.8)分。结论:在熟练掌握踝关节镜技术和严格把握适应证的前提下,采用全踝关节镜下复位经皮内固定治疗Maisonneuve骨折疗效确切、安全性较高,而且具有创伤小、术中可发现和处理关节内软骨病变的优势。

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备注/Memo

备注/Memo:
基金项目:浙江省卫生健康委医药卫生科技计划项目(2020ZH063)
通讯作者:杜俊锋 E-mail:dujunfeng_1982@163.com
更新日期/Last Update: 1900-01-01