特殊类型踝部骨折36例手术治疗分析

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1、提要目的：探讨分析特殊类型踝部骨折的创伤机制、骨折特点及手术治疗顺序，提高踝关节骨折的治愈率。方法：山东省中医院2009年4月至2011年10月收治的行切开复位内固定治疗的特殊类型踝部骨折患者共36例，年龄18～50岁，受伤原因为滑板伤、打篮球损伤、跌落伤和车祸伤，滑板损伤9例，打篮球损伤13例，坠落伤8例，车祸伤6例。均为高能量损伤。其中男26例，女10例。术前进行常规检查及X线分析，排除禁忌，确定手术时机，进行手术治疗。术中注意切口的选择，骨折复位的顺序。并将30例患者分成两组利用不同手术顺序进行手术。术后指导患者进行规范的功能锻炼，降低并发症的发生率。从中选出30位病

2、人分成两组用不通顺序手术，术后进行随访，随访时间最短者6个月，最长者15个月，依据Mazur踝关节评价分级系统进行评分，观察疗效。结果：30例患者，A组15例，优11例，良3例，可1例，优良率为93.33%。B组15例，优4例，良8例，可3例，优良率为80.00%。结论：对于特殊类型踝部骨折应早期手术治疗，术前充分了解骨折及脱位情况，并且选择更为合理的手术顺序，尽可能使骨折解剖对位，术后早期进行合理系统的功能锻炼。这样既可以缩短手术时间，降低复位的难度，还可以提高治疗的优良率，降低创伤性关节炎等并发症的发生率。关键词骨折；踝关节；特殊类型；手术治疗Specialtypeth

3、eanklefractures(36cases)surgeryanalysisSpeciality:OrthopedicsAuthor:DuanYuanMengTutor:Prof.WangMingXiAbstractObjective:tostudythespecialtypesoftraumamechanismanklefractures,fracturecharacteristicsandsurgicalorder,improvethecurerateanklefracturesMethods:hospitalinshandongprovinceinApril2009

4、toOctober2011linewereinternalfixation(orif)specialtypetheanklefracturesofpatientswith36cases,age18to50yearsold,wounded,reasonforskateboardinginjury,playingbasketballdamage,injuryandcaraccidentinjuryfall,skateboarddamage9cases,playingbasketballinjuryin13,fallinginjuryin8cases,6casesofcaracc

5、identinjury.Allforthehigh-energyinjuries.Themale26cases,female10cases.PreoperativeX-rayanalysisandroutineinspection,eliminatetaboo,determinetheoperationtime,forsurgery.Payattentiontothechoiceofintraoperativeincision,fracturerestorationofthesequence.Andwillbe30patientsintotwogroupswithdiffe

6、rentoperationorderoperation.Postoperativepatientswiththefunctionoftheguidanceofregulatingexercise,reducetheincidenceofcomplications.30patientswithfollow-upafter,follow-uptimetheshortestsixmonths,thelongest15months,accordingtoMazurankleevaluationclassificationratingsystem,observethecurative

7、effect.Results:30patients,Agroupof15cases,theoptimal11cases"good"in3,canbein1,was93.33%.GroupBin15cases,optimal4cases"good"in8cases,canbein3,was80.00%.Conclusion:forspecialtypetheanklefracturesshouldbeearlysurgicaltreatment,preoperativefullyunderstandthefractu