急诊经内踝截骨入路治疗距骨颈骨折合并距骨体脱位

目的：探讨急诊经内踝截骨入路治疗距骨颈骨折合并距骨体脱位的疗效。方法：1995年6月至2007年10月收治24例距骨颈骨折合并距骨体脱位患者,男18例,女6例;年龄28～58岁,平均35.4岁。伤后到就诊时间0.5～12h。右侧15例,左侧9例;闭合伤22例,开放性创伤2例。均在入院后5h内采用急诊经内踝截骨入路整复固定。结果：24例均获随访,时间6～60个月,采用Kenwright评定标准,优18例,良4例,可2例,差0例。结论：急诊经内踝截骨手术入路,操作简单,显露清楚,复位固定容易,对距骨血运破坏小,是治疗距骨颈骨折合并距骨体脱位,降低距骨坏死率的有效方法。

Emergency medial malleolus osteotomy for the treatment of fractures of talar neck combined with dislocation of talar body

Objective: To explore therapeutic effects of emergency medial malleolus osteotomy for the treatment of fractures of talar neck and dislocation of talar body. Methods: From 1995. 6 to 2007. 10,among 24 patients with fractures of talar neck and dislocation of talar body,18 patients were male and 6 patients were female,ranging in age from 28 to 58 years(mean 35.4 years). The duration from injury to the emergency ward ranged from 0.5 to 12 h. All the patients were treated in 5 hours after hospitalization with emergency medial malleolus osteotomy and internal fixation. Firstly,osteotomy was made above the medial malleolus tip;Secondly,the medial malleolus was turned over downward to uncover the talus; Then,the fracture of talus can be reduced in direct vision. Results: All the patients were followed up ranged from 6 to 60 months. According to Kenwright evaluation standards,18 patients obtained an excellent results,4 good and 2 fair. Conclusion: It is easy and clearly to perform medial malleolus osteotomy. The blood circulation of talus is preserved. So it is an effective method to treat the fractures of talar neck and dislocation of talar body.