| 孙法同,贾代良,王海滨,高肇篷,赵键,吕琳.漂浮体位下后外侧联合前内侧入路治疗三踝骨折的疗效[J].济宁医学院学报,2021,44(6):420-423 |
| 漂浮体位下后外侧联合前内侧入路治疗三踝骨折的疗效 |
| The efficacy of posterolateral combined with anteromedial approach in the treatment of trimalleolar fracture in floating position |
| 投稿时间：2021-04-15 |
| DOI：10.3969/j.issn.1000-9760.2021.06.010 |
| 中文关键词: 漂浮体位;手术入路;三踝骨折;内固定 |
| 英文关键词: Floating position;Surgical approach;Trimalleolar fracture;Internal fixation |
| 基金项目:山东省自然科学基金（ZR2015HL027） |
| 作者 | 单位 | E-mail | | 孙法同 | 济宁医学院临床医学院, 济宁 272013 | | | 贾代良 | 济宁医学院临床医学院, 济宁 272013
济宁医学院附属医院, 济宁 272029 | | | 王海滨 | 济宁医学院附属医院, 济宁 272029 | | | 高肇篷 | 济宁医学院附属医院, 济宁 272029 | | | 赵键 | 济宁医学院临床医学院, 济宁 272013 | | | 吕琳 | 济宁医学院临床医学院, 济宁 272013 | zdlvlin@163.com |
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| 中文摘要: |
| 目的 探讨漂浮体位下后外侧联合前内侧入路治疗三踝骨折的手术方法及疗效。方法 回顾性分析2015年1月至2020年1月济宁医学院附属医院收治的32例三踝骨折患者的临床资料和随访结果,其中男性19例,女性13例,年龄14～75岁,平均39.8岁。根据Lauge-Hansen分型,其中旋后外旋23例,旋前外旋6例,旋前外展3例,均一期行切开复位内固定手术治疗。结果 手术时间56～110min,平均81.8min,术后随访12～22个月,平均16.3个月,所有患者均达到骨性愈合,未发生神经及血管的损伤,未出现钢板螺钉松动或断裂。根据美国足踝外科协会(AOFAS)踝-后足评分标准,32例患者中优18例,良11例,可3例,优良率90.6%。结论 采用漂浮体位下后外侧联合前内侧入路治疗三踝骨折,便于更换术中体位,可充分暴露踝关节内侧、外侧和后侧的骨折,固定效果好,疗效显著,值得在临床推广应用。 |
| 英文摘要: |
| Objective To explore the surgical method and curative effect of posterolateral combined with anteromedial approach in the treatment of trimalleolar fracture.Methods The clinical data and follow-up results of 32 patients with trimalleolar fracture treated in the affiliated Hospital of Jining Medical University from January,2015 to January,2020 were analyzed retrospectively,including 19 males and 13 females,aged from 14 to 75 years(mean 39.8 years).According to Lauge-Hansen classification,there were 23 cases of pronation and external rotation,6 cases of pronation and external rotation and 3 cases of pronation and abduction.All patients were treated with open reduction and internal fixation in one stage.Results The operation time ranged from 56 to 110 minutes,with an average of 81.8 minutes.All patients were followed up for 12 to 22 months with an average of 16.3 months.All patients achieved bony healing,no nerve and vascular injury,no plate screw loosening or fracture.According to the ankle-posterior foot scoring criteria by American Orthopedic Foot and Ankle Society(AOFAS),among the 32 patients,excellent in 18 cases,good in 11 cases,fair in 3 cases,with an excellent and good rate of 90.6%.Conclusion The treatment of trimalleolar fracture with posterolateral combined with anteromedial approach in floating position is convenient to change the position during operation,and can fully expose the medial,lateral and posterior fractures of ankle joint.The fixation effect is good and the curative effect is remarkable.It is worthy to be widely used and popularized in clinical treatment. |
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