经皮中空螺钉内固定治疗后踝骨折的临床体会

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1、经皮微创中空螺钉内固定治疗后踝骨折的临床体会施保华沈决心上海市崇明县堡镇人民医院骨科202157【摘要】目的总结经皮中空螺钉治疗踝关节骨折中后踝骨折的手术疗效、适应症和注意事项。方法自2005年3月-2010年6月，手术治疗后踝骨折31例。男21例，女10例；所有患者术前常规进行踝关节X线和螺旋CT检查，了解后踝骨折块大小、移位情况以及横断面主骨折线与踝关节水平线所成的角度。根据CT分类Ⅰ型27例，Ⅱ型4例，Ⅲ型0例。应用改良的Baird-Jackson评分系统对其术后疗效进行评定，并将骨折类型、骨折固定方法、术后功能锻炼时间与最终功能的关系进行分析。结果随访时间为6-36个月，平

2、均18个月。31例疗效为：优23例，良6例，可2例，差0例，优良率为93.5%。结论经皮微创中空螺钉内固定具有固定可靠、创伤小、减少感染等优势，是一种有效安全的手术术式，值得临床推广和应用。【关键词】后踝骨折；骨折内固定；踝关节骨折手术治疗；中空螺钉TheclinicalsignificanceofposteriormalleolarfracturebyfixationwithminimallyinvasivepercutaneouscannulatedscrewsSHIBaohuaSHENJuexinDepartmentofOrthopedics,ThePeople’sHospi

3、talofBaoZhen;ChongMing;ShangHai;202157AbstractObjectiveTosummarizethesurgicalcurativeeffect．MajorIndicationsandnoticesofposteriormalleolarfracturebyfixationwithminimallyinvasivepercutaneouscannulatedscrewsMethodsThirty-onepatientswithposteriormalleolarfractureweretreatedwithminimallyinvasivepe

4、rcutaneouscannulatedscrewsfromMarch2005toJune2010.Thepatientsgroupsconsistedof21malesand10females.Allthepatientspreoperativeradiographandcomputedtomographicscanswerereviewed，andeachfracturewascategorizedaccordingtothesize.1ocationandfracturelineofthemajorfragmentandthestablestateofmortise.Acco

5、rdingtoCTscanclassification,thegroupwasmadeupof27typeⅠcases,4typeⅡand0typeⅢcases.AllpatientswereevaluatedwithmodifiedBaird-Jacksonscoringsystem.Therelationshipbetweenfinalresultandfracturepattern,fixationmethods,thetimeofexerciseinitiationfittedoperationwereanalyzedrespectively.ResultsThefollo

6、wed-upperiodvariedfrom6monthsto36months,withanaverageof18months.Thenumberofpatientswhoseresultwasexcellent,good,fairandpoorwasrespective23,6,2and0.Thetotalpercentageofgoodtoexcellentclinicalresultwas93.5%.ConclusionThetreatmentofposteriormalleolarfracturebyfixationwithminimallyinvasivepercutan

7、eouscannulatedscrewswasaeffectiveandsafesurgicaloperation.It’sadvantagewasreliablefixation,minimallyinvasionandminimizinginfectionetal.It’samethodworthyofourclinicalpopularizationandapplication.Keywords　FracturesofPosteriormalleolus(FPM