特殊类型踝部骨折36例手术治疗分析Analysis of surgical treatment for 36 cases of special ankle fractures.pdfVIP

提 要 目的：探讨分析特殊类型踝部骨折的创伤机制、骨折特点及手术治疗顺序，提高 踝关节骨折的治愈率。 方法：山东省中医院 2009 年 4 月至 2011 年 10 月收治的行切开复位内固定治疗 的特殊类型踝部骨折患者共36例，年龄18～50岁，受伤原因为滑板伤、打篮球损伤、 跌落伤和车祸伤，滑板损伤 9 例，打篮球损伤 13 例，坠落伤 8 例，车祸伤 6 例。均 为高能量损伤。其中男26例，女10例。术前进行常规检查及X线分析，排除禁忌， 确定手术时机，进行手术治疗。术中注意切口的选择，骨折复位的顺序。并将 30 例 患者分成两组利用不同手术顺序进行手术。术后指导患者进行规范的功能锻炼，降低 并发症的发生率。从中选出 30 位病人分成两组用不通顺序手术，术后进行随访，随 访时间最短者 6 个月，最长者 15 个月，依据 Mazur 踝关节评价分级系统进行评分， 观察疗效。 结果：30例患者，A组15例，优11例，良3例，可1例，优良率为93.33%。B 组15例，优4例，良8例，可3例，优良率为80.00%。 结论：对于特殊类型踝部骨折应早期手术治疗，术前充分了解骨折及脱位情况， 并且选择更为合理的手术顺序，尽可能使骨折解剖对位，术后早期进行合理系统的功 能锻炼。这样既可以缩短手术时间，降低复位的难度，还可以提高治疗的优良率，降 低创伤性关节炎等并发症的发生率。 关键词 骨折；踝关节；特殊类型；手术治疗 Special type the ankle fractures (36 cases) surgery analysis Speciality:Orthopedics Author:Duan YuanMeng Tutor:Prof. Wang MingXi Abstract Objective: to study the special types of trauma mechanism ankle fractures, fracture characteristics and surgical order, improve the cure rate ankle fractures Methods: hospital in shandong province in April 2009 to October 2011 line were internal fixation (orif) special type the ankle fractures of patients with 36 cases, age 18 to 50 years old, wounded, reason for skateboarding injury, playing basketball damage, injury and car accident injury fall, skateboard damage 9 cases, playing basketball injury in 13, falling injury in 8 cases, 6 cases of car accident injury. All for the high-energy injuries. The male 26 cases, female 10 cases. Preoperative X-ray analysis and routine inspection, eliminate taboo, determine the operation time, for surgery. Pay attention to the choice of intraoperative incision, fracture restoration of the sequence. And will be 30 patients into two groups with different operation order operation. Postoperative patients with the fu