距下关节截骨缓慢延长治疗陈旧性
《创伤外科杂志》[ISSN:/CN:]
- 期数:
- 2011年03期
- 页码:
- 8
- 栏目:
- 临床研究
- 出版日期:
- 2011-07-30
文章信息/Info
- Title:
- External fixation and gradual limb lengthening for complicated delayed calcaneal fractures: report of 12 cases
- Author(s):
- FAN Weili; WANG Ziming; ZHAO Yufeng; et al.
- Department of Orthopedics,Institute of Surgery Research,Daping Hospital,Third Military Medical University,Chongqing400042,China
- 分类号:
- R683.42
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的伴有距下关节损伤的陈旧性跟骨骨折，目前主要是采用距下关节原位融合术和距下关节牵伸骨块植入融合术治疗，在此介绍一种新手术方式，距下关节截骨外固定支架缓慢延长手术，并评估其疗效。方法12例15足（单足9例，双足3例）陈旧性跟距关节骨折脱位，年龄1653岁，平均33.6岁。闭合性7例（10足）,开放型性5例（5足）。开放性损伤中3例严重多发伤病人手术时伤口已愈合2个月以上，2例伤口仍未愈合。均采用距下关节截骨牵伸融合新方法治疗，术中行内、外侧骨突切除、距下关节截骨与植骨、Orthofix外固定支架固定，术后710天延长，至距下关节间隙牵开12cm、跟骨高度和Bohler角基本恢复正常时结束延长，23个月后距下关节骨性融合后取出外固定支架开始负重行走。结果12例（15足）得到了650个月的随访,伤口均愈合，无皮肤坏死。距下关节在3~6个月（平均3.7个月）得到骨性融合。采用美国骨科足踝外科学会（AOFAS）评分标准，平均由术前的24.2分提高到术后随访时的76.8分。结论距下关节截骨缓慢延长治疗陈旧性跟骨骨折是一种新的有效治疗方法；无皮肤坏死、无需植骨和内固定；用于开放性陈旧性跟骨骨折的治疗可明显缩短疗程。
参考文献/References
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备注/Memo
- 备注/Memo:
- -
