本文選題：后踝 + 骨折��； 參考：《山西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:比較鋼板固定與單純空心拉力螺釘內(nèi)固定在治療大塊后踝骨折時(shí)的療效,為臨床工作提供參考。方法:選取自山西醫(yī)科大學(xué)第二醫(yī)院自2012年4月至2014年12月間,采用手術(shù)治療涉及踝關(guān)節(jié)面大于25%的后踝骨折患者54例。其中29例采用鋼板固定(鋼板組),其中男性14例,女性15例,年齡18-69歲,平均年齡40.25歲。據(jù)Lauge-Hansen分型標(biāo)準(zhǔn):旋后外旋III度9例,IV度13例;旋前外旋IV度7例。25例采用空心螺釘固定(螺釘組),其中男性14例,女性11例,年齡19-66歲,平均年齡40.44歲。據(jù)Lauge-Hansen分型標(biāo)準(zhǔn):旋后外旋III度9例,IV度11例;旋前外旋IV度5例。術(shù)后定期隨訪并根據(jù)美國(guó)足踝外科協(xié)會(huì)(AOFAS)的踝-后足評(píng)分標(biāo)準(zhǔn)評(píng)價(jià)踝關(guān)節(jié)功能。記錄兩種治療方法患者關(guān)節(jié)功能(術(shù)后1年AOFAS評(píng)分)、骨折愈合時(shí)間、完全負(fù)重時(shí)間及相關(guān)并發(fā)癥等差異。結(jié)果:1例患者(鋼板組)失隨訪,其余53例患者均獲隨訪,隨訪時(shí)間10~16個(gè)月,平均13.7個(gè)月。兩組患者骨折愈合時(shí)間、完全負(fù)重時(shí)間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),但末次隨訪AOFAS評(píng)分比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:對(duì)于骨折塊累及踝關(guān)節(jié)面大于25%的后踝骨折,鋼板及螺釘均為有效治療方法。但相比于單純空心拉力螺釘固定,鋼板可以使踝關(guān)節(jié)功能在早期得到最大限度恢復(fù),提高手術(shù)治療效果。
[Abstract]:Objective: to compare the effect of plate fixation and hollow screw fixation in the treatment of large posterior ankle fracture. Methods: from April 2012 to December 2014, 54 patients with posterior malleolus fracture involving more than 25% of the ankle surface were treated with surgical treatment from the second Hospital of Shanxi Medical University. Among them, 29 cases were fixed with steel plate (steel plate group, 14 males and 15 females, aged 18-69 years, mean age 40.25 years). According to Lauge-Hansen classification criteria, 9 cases of III degree and 7 cases of IV degree were treated with hollow screw fixation (screw group, 14 males and 11 females, age 19-66 years, mean age 40.44 years). According to Lauge-Hansen classification criteria, 9 cases had III degree of circumflex and 11 cases had grade IV, 5 cases had degree IV of pronation. The ankle function was evaluated according to the ankle-hind foot score of the American Association of foot and ankle Surgeons. The differences of joint function (AOFAS score, fracture healing time, total weight loading time and related complications) between the two treatments were recorded. Results one patient (steel plate group) was followed up, the other 53 cases were followed up for 10 ~ 16 months (mean 13.7 months). There was no significant difference in fracture healing time and total weight bearing time between the two groups (P 0.05), but there was significant difference in AOFAS score at the last follow-up (P 0.05). Conclusion: plate and screw are effective for the fracture of the posterior malleolus fracture in which the ankle joint is more than 25%. But compared with hollow screw fixation, plate can make ankle function recover as early as possible and improve the effect of surgical treatment.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 張志剛;劉沂;于一民;;改良后內(nèi)外側(cè)手術(shù)入路在后踝骨折治療中的應(yīng)用[J];中國(guó)骨與關(guān)節(jié)損傷雜志;2012年04期

2 趙文;唐佩福;彭海州;趙太茂;;后踝固定治療踝關(guān)節(jié)骨折的臨床療效[J];中國(guó)修復(fù)重建外科雜志;2010年12期

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本文編號(hào)：1824390