發(fā)布時(shí)間：2018-03-15 10:40

  本文選題：踝關(guān)節(jié)骨折　切入點(diǎn)：.小鋼板螺釘　出處：《中國(guó)矯形外科雜志》2017年14期 　論文類型：期刊論文

【摘要】：[目的]探討踝關(guān)節(jié)骨折中恢復(fù)Tillaux-Chaput骨塊解剖結(jié)構(gòu)的治療方法及重要性。[方法]2011年5月~2015年5月,采用切開復(fù)位內(nèi)固定術(shù)治療13例累及Chaput骨塊的成人踝關(guān)節(jié)骨折患者。男8例,女5例;年齡19~45歲,平均32歲。致傷原因:運(yùn)動(dòng)損傷4例,交通事故傷3例,高處墜落傷6例。旋后外旋型6例,旋前外旋型7例,左側(cè)8例,右側(cè)5例;單獨(dú)Tillaux-Chaput撕脫骨折1例,合并踝關(guān)節(jié)周圍骨折者12例。對(duì)Chaput骨折中采用常規(guī)腓骨前外側(cè)切口,直視復(fù)位后以2.7小鋼板擠壓骨塊,并以螺釘固定;外踝及Chaput骨塊取外踝改良切口,即沿外踝骨干向踝前做弧形延伸,外踝用解剖鋼板內(nèi)固定,Chaput骨塊直視下復(fù)位,以2.7小鋼板螺釘固定。[結(jié)果]術(shù)后患者傷口愈合良好,13例均獲隨訪3~24個(gè)月,平均14個(gè)月,復(fù)查X線檢查,骨折愈合時(shí)間1.5~4個(gè)月,術(shù)后即開始踝關(guān)節(jié)功能鍛煉,術(shù)后6周扶拐逐漸負(fù)重行走,療效根據(jù)美國(guó)足踝矯形協(xié)會(huì)的足踝評(píng)分(AOFAS)標(biāo)準(zhǔn)86~100分:優(yōu)10例,良3例。[結(jié)論]Chaput骨塊對(duì)踝關(guān)節(jié)有重要作用,小鋼板螺釘治療Chaput骨折有利于患者踝關(guān)節(jié)功能恢復(fù),可獲得很好臨床療效。
[Abstract]:[objective] to explore the treatment and importance of restoring the anatomical structure of Tillaux-Chaput bone mass in ankle fracture. [methods] from May 2011 to May 2015, 13 cases of adult ankle fracture involving Chaput bone mass were treated with open reduction and internal fixation. The causes of injury included sports injury (4 cases), traffic accident (3 cases), falling injury (6 cases), circumflex type (6 cases), circumflex type (7 cases), left side (8 cases) and right side (5 cases). Only 1 case of Tillaux-Chaput avulsion fracture, 12 cases complicated with fracture around ankle joint. The conventional anterolateral fibula incision was used in Chaput fracture. After direct reduction, the bone mass was pressed with 2.7 small steel plate and fixed with screw. The modified incision of lateral malleolus and Chaput bone mass was taken from lateral malleolus and Chaput bone block. That is to say, the lateral malleolus extended to the front of the ankle along the shaft of the lateral malleolus, and the lateral malleolus was fixed with dissecting plate and Chaput bone mass under direct vision, and was fixed with 2.7 small plate and screw. [results] 13 cases with good wound healing after operation were followed up for 3 ~ 24 months (mean 14 months). X-ray examination showed that the healing time of fracture was 1.5 ~ 4 months, the functional exercise of ankle joint was started immediately after operation, and the walking was gradually carried by the crutch 6 weeks after operation. The curative effect was based on the standard of AOFAS86 ~ 100 of the American ankle Orthopedic Association: 10 cases were excellent. [conclusion] Chaput bone graft plays an important role in ankle joint. Small plate and screw treatment of Chaput fracture is beneficial to the recovery of ankle function and can obtain good clinical effect.
【作者單位】： 山東泗水縣人民醫(yī)院外一科;濟(jì)南軍區(qū)總醫(yī)院創(chuàng)傷骨科研究所;
【分類號(hào)】：R687.3

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