踝部骨折治疗中Chaput结节损伤修复的重要性

发布时间：2018-03-15 10:40

本文选题：踝关节骨折　切入点：.小钢板螺钉　出处：《中国矫形外科杂志》2017年14期 　论文类型：期刊论文

【摘要】：[目的]探讨踝关节骨折中恢复Tillaux-Chaput骨块解剖结构的治疗方法及重要性。[方法]2011年5月~2015年5月,采用切开复位内固定术治疗13例累及Chaput骨块的成人踝关节骨折患者。男8例,女5例;年龄19~45岁,平均32岁。致伤原因:运动损伤4例,交通事故伤3例,高处坠落伤6例。旋后外旋型6例,旋前外旋型7例,左侧8例,右侧5例;单独Tillaux-Chaput撕脱骨折1例,合并踝关节周围骨折者12例。对Chaput骨折中采用常规腓骨前外侧切口,直视复位后以2.7小钢板挤压骨块,并以螺钉固定;外踝及Chaput骨块取外踝改良切口,即沿外踝骨干向踝前做弧形延伸,外踝用解剖钢板内固定,Chaput骨块直视下复位,以2.7小钢板螺钉固定。[结果]术后患者伤口愈合良好,13例均获随访3~24个月,平均14个月,复查X线检查,骨折愈合时间1.5~4个月,术后即开始踝关节功能锻炼,术后6周扶拐逐渐负重行走,疗效根据美国足踝矫形协会的足踝评分(AOFAS)标准86~100分:优10例,良3例。[结论]Chaput骨块对踝关节有重要作用,小钢板螺钉治疗Chaput骨折有利于患者踝关节功能恢复,可获得很好临床疗效。
[Abstract]:[objective] to explore the treatment and importance of restoring the anatomical structure of Tillaux-Chaput bone mass in ankle fracture. [methods] from May 2011 to May 2015, 13 cases of adult ankle fracture involving Chaput bone mass were treated with open reduction and internal fixation. The causes of injury included sports injury (4 cases), traffic accident (3 cases), falling injury (6 cases), circumflex type (6 cases), circumflex type (7 cases), left side (8 cases) and right side (5 cases). Only 1 case of Tillaux-Chaput avulsion fracture, 12 cases complicated with fracture around ankle joint. The conventional anterolateral fibula incision was used in Chaput fracture. After direct reduction, the bone mass was pressed with 2.7 small steel plate and fixed with screw. The modified incision of lateral malleolus and Chaput bone mass was taken from lateral malleolus and Chaput bone block. That is to say, the lateral malleolus extended to the front of the ankle along the shaft of the lateral malleolus, and the lateral malleolus was fixed with dissecting plate and Chaput bone mass under direct vision, and was fixed with 2.7 small plate and screw. [results] 13 cases with good wound healing after operation were followed up for 3 ~ 24 months (mean 14 months). X-ray examination showed that the healing time of fracture was 1.5 ~ 4 months, the functional exercise of ankle joint was started immediately after operation, and the walking was gradually carried by the crutch 6 weeks after operation. The curative effect was based on the standard of AOFAS86 ~ 100 of the American ankle Orthopedic Association: 10 cases were excellent. [conclusion] Chaput bone graft plays an important role in ankle joint. Small plate and screw treatment of Chaput fracture is beneficial to the recovery of ankle function and can obtain good clinical effect.
【作者单位】：山东泗水县人民医院外一科;济南军区总医院创伤骨科研究所;
【分类号】：R687.3

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