本文選題：距骨頸骨折　切入點：前內(nèi)側(cè)切口入路　出處：《蘇州大學(xué)》2015年碩士論文

【摘要】：一、研究目的回顧性觀察比較兩種手術(shù)入路(單側(cè)前內(nèi)側(cè)切口入路和雙側(cè)切口入路)治療距骨頸骨折的臨床療效。二、研究方法2006年6月至2013年9月,共36例距骨頸骨折患者在常州市中醫(yī)院就診,其中隨訪資料完整的手術(shù)患者31例,分別采用了單側(cè)前內(nèi)側(cè)切口入路和雙側(cè)切口入路。根據(jù)其手術(shù)入路分成兩組:單切口組(15例)、雙切口組(16例)。運用統(tǒng)計學(xué)方法計算并比較兩組患者術(shù)后一年骨折的愈合率、創(chuàng)傷性關(guān)節(jié)炎和距骨缺血性壞死的發(fā)生率、Hawkins療效評定優(yōu)良率、VAS評分及AOFAS踝-后足評分。三、研究結(jié)果術(shù)后一年31例患者總體骨折愈合率為77.42%,其中單切口組為93.33%,雙切口組為62.50%。兩組患者在骨折愈合率方面有統(tǒng)計學(xué)差異(P0.05)。31例患者術(shù)后一年創(chuàng)傷性關(guān)節(jié)炎的發(fā)生率為29.03%,其中單切口組為46.67%,雙切口組為12.50%。單切口組創(chuàng)傷性關(guān)節(jié)炎的發(fā)生率高于雙切口組,差異有統(tǒng)計學(xué)意義(P0.05)。31例患者術(shù)后一年距骨缺血性壞死的發(fā)生率為16.13%,其中單切口組為13.33%,雙切口組為18.75%,兩組患者在距骨缺血性壞死的發(fā)生率方面無統(tǒng)計學(xué)差異(P0.05)。31例患者術(shù)后一年Hawkins療效評定總體優(yōu)良率為61.29%,其中單切口組為51.33%,雙切口組為68.75%,兩組患者的優(yōu)良率無統(tǒng)計學(xué)差異(P0.05)。術(shù)后一年,單切口組VAS評分為6.04±0.75,AOFAS評分為42.84±10.16;雙切口組VAS評分為為3.28±0.42,AOFAS評分為61.24±11.8;單切口組VAS評分高于雙切口組,AOFAS評分低于雙切口組,差異有統(tǒng)計學(xué)意義(P0.05)。四、研究結(jié)論單側(cè)前內(nèi)切口入路治療距骨頸骨折術(shù)后一年的骨折愈合率高于雙側(cè)切口入路,而創(chuàng)傷性關(guān)節(jié)炎的發(fā)生率較雙側(cè)切口入路高。單側(cè)前內(nèi)切口入路和雙側(cè)切口入路治療距骨頸骨折術(shù)后一年AVN的發(fā)生率及Hawkins療效評定優(yōu)良率無明顯差異,而單側(cè)前內(nèi)切口入路術(shù)后一年的VAS評分略高于雙側(cè)切口入路,術(shù)后一年的AOFAS評分略低于雙側(cè)切口組。兩種手術(shù)入路各有優(yōu)缺點,應(yīng)根據(jù)術(shù)前資料及術(shù)中所見靈活選擇。
[Abstract]:Objective: to retrospectively observe and compare the clinical efficacy of two surgical approaches (unilateral anterior medial incision and bilateral incision approach) in the treatment of talus neck fractures. A total of 36 patients with fracture of talus neck were treated in Changzhou Hospital of traditional Chinese Medicine. Unilateral anteromedial incision approach and bilateral incision approach were used respectively. According to the surgical approach, the patients were divided into two groups: single incision group (n = 15) and double incision group (n = 16). The rate of fracture healing in two groups was calculated and compared by statistical method. The incidence of traumatic arthritis and avascular necrosis of talus. Results the overall fracture healing rate of 31 patients one year after operation was 77.42, including 93.33 in the single incision group and 62.50 in the double incision group. There was a significant difference in fracture healing rate between the two groups (P 0.05). 31 cases of traumatic arthritis occurred one year after operation. The incidence of traumatic arthritis in the single incision group was higher than that in the double incision group. The incidence of avascular necrosis of talus was 16.13 in one year after operation, including 13.33 in the single incision group and 18.75 in the double incision group. There was no significant difference in the incidence of avascular necrosis of the talus between the two groups (P 0.05). The total excellent and good rate of Hawkins one year after operation was 61.29, including 51.33 in the single incision group and 68.75 in the double incision group. There was no significant difference in the excellent and good rates between the two groups (P 0.05). The VAS score of single incision group was 6.04 鹵0.75 VAS score was 42.84 鹵10.16, the VAS score of double incision group was 3.28 鹵0.42 VAS score was 61.24 鹵11.8.The VAS score of single incision group was higher than that of double incision group, and the difference was significant (P 0.05). Conclusion the fracture healing rate of unilateral anterior internal incision approach is higher than that of bilateral incision approach one year after the treatment of talus neck fracture. However, the incidence of traumatic arthritis was higher than that of bilateral incision approach. There was no significant difference in the incidence of AVN and the excellent and good rate of Hawkins evaluation between unilateral anterior incision approach and bilateral incision approach in the treatment of talus neck fracture one year after operation. The VAS score of unilateral anterior internal incision was slightly higher than that of bilateral incision one year after operation, and the AOFAS score of one year after operation was slightly lower than that of bilateral incision group.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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本文編號：1660349