内踝截骨方法治疗距骨颈骨折临床效果.docVIP

内踝截骨方法治疗距骨颈骨折临床效果 　　[摘要]目的 探讨内踝截骨治疗复杂距骨颈骨折的临床疗效和价值。方法 回顾性分析本院2010年10月～2015年10月收治的50例距骨颈骨折患者，应用经内踝截骨手术入路及传统手术入路空心钉内固定术两种方法将其分为实验组25例和对照组25例，比较两组患者的手术时间、术后并发症、创口愈合时间等指标。结果 实验组经治疗，优：23例，占92%，良：1例，占4%，可：1例，占4%，差：0例，占0%，优良率为96%；对照组经治疗，优：18例，占72%，良：3例，占12%，可：3例，占12%，差：1例，占4%，优良率为84%，两组优良率比较，差异有统计学意义（P0.05）。实验组手术时间为（80±5）min，明显低于对照组的（110±10）min，差异有统计学意义（P0.05）。结论 内踝截骨方法治疗距骨颈骨折操作简便，固定性好，创伤性小，不良反应少，降低距骨缺血坏死的发生率，优于传统手术入路，值得临床推广。 　　[关键词]距骨骨折； 内踝截骨；临床疗效 　　[中图分类号] R687 [文献标识码] A [文章编号] 1674-4721（2016）06（c）-0057-04 　　[Abstract]Objective To explore the clinical effect and value of internal malleolous osteotomy in the treatment of complex talar neck fracture.Methods From October 2010 to October 2015，50 patients with talar neck fracture admitted into our hospital was retrospectively analyzed.By cannulated screw for internal fixation via internal malleolous osteotomy and traditional surgical approach，they were evenly divided into experimental group and control group in random.Based on operation time，postoperative complications，and wound healing time，the therapeutic effect was compared.Results By different methods in the two groups，according to Hawkins efficacy evaluation standard，the number of excellent，good，acceptable and poor cases was 23 cases （92%），1 case （4%），1 case （4%），and 0 case （0%） in the experimental group，and the excellent and good rate was 96%.In the control group，the number was 18 cases （72%），3 cases （12%），3 cases （12%），and 1 case （4%） respectively，and the excellent and good rate was 84%.The operation time in the experimental group was （80±5） min，greatly shorten than that in the control group of （110±10） min with a statistical difference （P0.05）.Conclusion In the treatment of talar neck fracture，internal malleolous osteotomy is simple in performance with advantages of good fixation，small wound，and few adverse reactions.It can decrease the incidence of avascular necrosis in talus and is better than by traditional surgical approach，which is worthy of clinical promoti