三踝骨折的手术治疗及术后康复锻炼的临床研究

发布时间：2018-05-16 03:35

本文选题：三踝骨折 + 后外侧切口　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:三踝骨折是日常较为常见但损伤严重的骨折,复位要求较高,本文旨在研究后外侧入路的手术方式配合“动静平衡”的功能锻炼方法对患者功能恢复的影响。方法:选择三踝骨折的患者36例,术中外踝及后踝取后外侧切口,先固定后踝,后踝复位后采用空心钉固定,沿同切口向前分离至外踝,外踝复位后用解剖钢板固定,最后取内踝内侧切口,复位内踝后用空心钉固定。术后根据患者个人具体身体情况进行功能康复锻炼指导,以量化的最小有效康复量为宜。结果:36例患者均达到骨性愈合,骨折愈合时间为10-17周。无骨性关节炎的发生,12个月复查时所有患者均可正常行走,无一发生内固定失败,X线显示所有骨折线均消失,AOFAS评分:优:29例,良:6例,可:1例,差:0例。优良率可达97.2%。结论:1.后外侧切口可在直视下复位,复位容易且复位情况较好,减少了台阶的形成,降低了骨性关节炎的发生。2.“动静平衡”的功能锻炼方法是科学的术后功能康复指导,在保证了患者骨折稳定性的前提下,使关节功能得到了很好的恢复。
[Abstract]:Objective: trimalleolar fracture is a common fracture with severe injury, and the reduction requirement is high. The purpose of this paper is to study the effect of posterior lateral approach combined with "static and dynamic balance" on the functional recovery of patients. Methods: 36 cases of trimalleolar fracture were selected. The lateral and posterior malleolus were taken from the lateral incision during the operation, the posterior malleolus was fixed first, the posterior malleolus was fixed with hollow nail, the lateral malleolus was separated to the lateral malleolus along the same incision, and the lateral malleolus was fixed with anatomic plate after reduction. Finally, medial incision of medial malleolus was taken and fixed with hollow nail after reduction of medial malleolus. Functional rehabilitation exercise guidance was conducted according to the individual physical condition of the patient after operation, and the minimum effective rehabilitation quantity was the best. Results the bone healing time was 10-17 weeks in 36 cases. There was no occurrence of osteoarthritis, all patients could walk normally after 12 months reexamination, and none of them had internal fixation failure and X-ray showed that all fracture lines disappeared with AOFAS score: you: 29 cases, good: 6 cases, fair 1 case, poor: 0 case. The excellent and good rate can reach 97.2%. Conclusion 1. The posterolateral incision can be reduced under the direct vision. The reduction is easy and the reduction is better, which reduces the formation of steps and the occurrence of osteoarthritis. The "dynamic and dynamic balance" functional exercise method is a scientific guidance for functional rehabilitation after operation, which ensures the stability of fracture and makes the joint function recover well.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.1

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