开放性踝关节完全脱位的处理

发布时间：2018-11-19 15:01

【摘要】：[目的]探讨开放性完全踝关节脱位的手术方法和治疗效果。[方法]回顾性分析2008年12月~2016年1月,手术治疗的26例开放性踝关节脱位患者资料,男24例,女2例;年龄21~60岁,平均35.2岁。通过X线片观察术后骨折复位及脱位纠正情况、骨折愈合情况及内固定牢固程度,并定期按改良的Baird和Jackson踝关节评分标准对踝关节功能进行评估。[结果]24例患者获得随访,2例失访。经过10~26个月的随访(平均18个月),术后X线片示骨折脱位均获得良好复位,后期无内固定松动、断裂等并发症发生,骨折全部愈合,愈合时间为2~4个月,平均2.8个月。末次随访时Baird和Jackson踝关节评分为75~100分,平均96.06分,优13例,占54.17%;良9例,占37.50%;可1例,占4.17%;差1例,占4.17%。优良率为91.67%。[结论]针对开放性踝关节脱位的治疗不仅仅是彻底的清创,也不仅仅是骨折的复位与稳定,需要同时注重踝关节周围软组织平衡的重建。
[Abstract]:Objective: to investigate the operative method and treatment effect of open complete ankle dislocation. [methods] from December 2008 to January 2016, 26 patients (24 males and 2 females) with open ankle dislocation, aged from 21 to 60 years, with an average age of 35.2 years, were analyzed retrospectively. The fracture reduction and dislocation correction, fracture healing and internal fixation were observed by X-ray film, and the ankle function was evaluated regularly according to the modified Baird and Jackson ankle scoring standards. [results] 24 patients were followed up and 2 patients lost their visits. After follow-up for 10 ~ 26 months (mean 18 months), X-ray films showed that all fractures and dislocations were well reduced, no internal fixation loosening, fracture and other complications occurred, all the fractures healed, and the healing time was 2 ~ 4 months (average 2.8 months). At the last follow-up, the scores of Baird and Jackson were 75 ~ 100 (average 96.06), excellent in 13 (54.17), good in 9 (37.50), fair in 1 (4.17), poor in 1 (4.17). The excellent and good rate was 91.67. [conclusion] the treatment of open ankle dislocation is not only complete debridement, but also the reduction and stability of fracture.
【作者单位】：山东省济南市第三人民医院骨外科;山东省济南市中心医院骨外科;山东省中医院关节外科;
【分类号】：R687.4

【相似文献】