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《创伤外科杂志》[ISSN:/CN:]

期数:

2020年08期

页码:

565-569

栏目:

论著(踝关节骨折)

出版日期:

2020-08-20

文章信息/Info

Title:

Efficacy of internal fixation in the treatment of complex middle foot injury complicated with ankle fracture

文章编号:

1009-4237(2020)08-0565-05

作者:

张正超; 何武兵; 蔡鸿儒; 郭立成; 林 昊

350001 福州,福建省立医院急诊外科,福建医科大学省立临床医学院

Author(s):

ZHANG Zheng-chao¹; 2; HE Wu-bing¹; 2; CAI Hong-ru¹; 2; GUO Li-cheng¹; 2; LIN Hao¹; 2

1.Department of Emergency Surgery,Fujian Provincial Hospital,Fuzhou 350001 China; 2.Provincial Clinical Medical College of Fujian Medical University,Fuzhou 350001,China

关键词:

中足损伤;  踝关节骨折;  内固定

分类号:

R 683.42

DOI:

10.3969j.issn.1009-4237.2020.08.002

文献标识码:

A

摘要:

目的 分析内固定治疗复杂中足损伤合并踝关节骨折的疗效及治疗要点。 方法 回顾性分析2012年5月—2019年2月福建省立医院27例合并踝关节骨折的复杂中足损伤患者,男性17例,女性10例; 年龄36～82岁,平均57.4岁; 高处坠落伤7例,道路交通伤8例,步行损伤2例,重物砸伤10例。遵照先固定踝关节后足部顺序,由近到远固定跗横关节、跗中关节、跖跗关节,由内到外依次固定足内、中、外侧柱,恢复足踝解剖结构,术后定期随访,拍摄足踝X线片,采用AOFAS中足评分表及踝-后足评分表对足踝功能进行疗效评价。结果 术后随访12～22个月,平均17.3个月。根据AOFAS中足及踝-后足评分表,本组患者中足评分优良率为70.37%,踝-后足评分优良率为66.67%。4例术后切口愈合欠佳并发感染,返院予清创抗感染治疗; 2例出现术后螺钉松动,返院取出松动螺钉。未出现骨不连、内植物异物反应等其他术后并发症。结论 对于合并踝关节骨折的复杂中足损伤,了解其损伤机制、损伤病理及分型,采取有效内固定能获得良好解剖复位及较好的术后功能康复。

参考文献/References

[1] Queen RM,Mall NA,Hardarker WM,et al.Describing the medical longitudinal arh using footprint indices and a clinical grading system[J].Foot Ankle Int,2007,28(4):456-462.
[2] 余霄,蒋鲁勇,刘丙根,等.跖跗关节新鲜损伤与陈旧损伤的手术疗效对比研究[J].中国骨与关节杂志,2015,4(2):106-110.
[3] Rammeh S,Obruba P.An update on the evaluation and treatment of syndesmotic injuries[J].Eur J Trauma Emerg Surg,2015,41(6):601-614.
[4] 骆渊城,王晶,敖传西,等.闭合复位与切开复位内固定治疗跖跗关节损伤的效果比较[J].中国医药导报,2017,14(3):102-105.
[5] 袁晓东,顾悦,钱襄.应用三柱理论治疗合并跟骨头部骨折和舟状骨骨折chopart关节损伤[J].实用手外科杂志,2017,31(4):497-499.
[6] Chiodo CP,Myerson MS.Developments and advances in the diagnosis and treatment of injuries to the tarsometarsal joint[J].Orthop Clin North(Am),2001,32(1):11-20.
[7] 张明珠,杨云峰,苗旭东,等.切开复位内固定与Ⅰ期融合治疗伴第一跖跗关节脱位Lisfranc损伤的疗效比较[J].中华创伤杂志,2018,34(7):585-590.
[8] Teng AL,Pinzur MS,Lomasney L,et al.Functional outcome following anatomic restoration of tarsalme tatarsal fractured is location [J].Foot Ankle Int,2012,32(10):922-926.
[9] Myerson MS,Fishe RT,Burgess AR,et al.Fracture dislocations of the tarsometatarsal joints:end results correlated with pathology and treatment[J].Foot Ankle,1986,6(5):225-242.
[10] 高鹏,张保中.前中足碾挫伤的疗效分析[J].中国骨与关节外科,2010,3(3):215-218.
[11] 徐向阳,李鸿庆,刘津浩,等.复杂中足损伤的临床治疗[J].中华创伤骨科杂志,2009,11(6):516-519.
[12] Fraissler L,Konrads C,Hoberg M,et al.Treatment of hallux valgus deformity[J].EFORT Open Rev,2016,1(8):295-302.
[13] Kaar S,Femino J,Morag Y.Lisfrane joint displacement following sequential ligament sectioning[J].J Bone Joint Surg(Am),2007,89(10):2225-2232.
[14] 王世毅.跖跗关节损伤采用切开复位双重加压螺钉固定治疗的临床体会[J].临床研究,2017,25(8):94-95.
[15] Knutsen AR,Fleming JF,Ebramzadeh E,et al.Biomechanical comparison of fixation devices for first metatarsocuneiform joint arthrodesis[J].Foot Ankle Spec,2017,10(4):322-328.
[16] Ly TV,Coetzee JC.Treatment of primarily ligamentous Lisfrane joint Injuries; primary arthmdesis compared with open reduction and internal fixation.A prospective.randomized study[J].J Bone Joint Surg(Am),2006,88(3):514-520.
[17] Porter DA,Barnes AF,Rund A.Walrod MT(2018)Injury pat-tern in ligamentous Lisfranc injuries in competitive athletes[J].Foot Ankle Int,2020,40(2):185-194.

备注/Memo

备注/Memo:

【通信作者】 林昊,E-mail:32348797@qq.com

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更新日期/Last Update: 2020-08-20