距骨颈骨折的手术治疗

目的探讨距骨颈骨折的手术治疗及并发症防治。方法回顾2000年至2004年手术治疗的距骨颈骨折12例,总结其手术入路、内固定方法及术后处理。结果所有患者均在术后12~14d伤口拆线出院,无伤口感染、不愈合或皮肤坏死发生。12例患者中有10例获得随访,随访7个月至5年,平均3年4个月。按Hawkins标准优2例、良7例、中1例,创伤性骨关节炎4例,距骨无菌性坏死2例。结论对于复位不理想的距骨颈骨折应积极行切开复位内固定,强调骨折的解剖复位,避免术后过早负重,降低术后并发症的发生几率。

Surgical treatment of talus neck fracture

Objective To study the surgical treatment of talus neck fracture and prevention of complications.Methods 12 cases of talus neck fracture were retrospectively analyzed between 2000 and 2004.The operative approaches,internal fixation methods and postoperative treatments were summarized.Results All cases were discharged from hospital on time without skin complication and 10 cases received a follow-up from 7 months to 5 years (mean 40 months),and the clinical results were excellent in 2 cases,good in 7 cases and common in 1 case according to Hawkins standard.The complications included traumatic osteoarthritis in 4 cases and aseptic necrosis in 2 cases.Conclusion Operative treatment should be performed actively when anatomic reduction of talus neck fracture is not achieved.Perfect anatomic reduction of the fracture,solid internal fixation and enough period off weight loading are recommended,which could lessen the probability of complications.