经内外踝截骨入路可吸收螺钉固定治疗复杂距骨体部骨折

[目的]介绍经内外踝截骨入路可吸收螺钉固定治疗复杂距骨体部骨折的方法,探讨其近期疗效.[方法]自1998年3月～2003年1月,收治复杂距骨体部骨折8例,男5例,女3例,年龄19～46岁,平均28.9岁;坠落伤4例,车祸伤3例;重物砸伤1例;左侧5例,右侧3例;合并踝部骨折2例,开放骨折脱位1例,均应用经内外踝截骨入路可吸收螺钉固定手术治疗.[结果]全部病例均获得随访1～3 a,平均1.3 a.根据患者主诉、后跟及踝关节的外形、功能及X线片征象来评价临床疗效.按Hawkins疗效标准：优4例（50%）,良2例（25%）,可l例（12.5%）,差1例（12.5%）,优良率为75%,本组病例均未出现距骨体坏死.[结论]经内外踝截骨入路可吸收螺钉固定手术是治疗复杂距骨体部骨折的良好方法.

Operative treatment of complex talar body fracture through approach of internal or external malleolus osteotomy and absorbable screw for fixation

[ Objective]To introduce an operative treatment of complex talar body fracture and discuss the therapeutic effect in the near future. [ Method] From March 1999 to January 2003, 8 patients of complex talar body fracture in our department were treated. There were 5 males and 3 females with an average age of 28.9 years from 19 years to 46 years. The injuries were caused by fall in 3 cases,traffic accident in 3 cases,crash in 1 case,and on left 5 cases,fight 3 cases. Two cases were combined with malleolus fracture and 1 case with open fracture and dislocation. All patients were treated with operation through approach of internal or external malleolus osteotomy and useing absorbable screw for fixation. [ Result] All the patients were followed up 1 to 3 years ,average 1.3 year. By the assessment of clinical effects dependingon the complaints ,functions and radiological results of the ankle and subtalar joint ,4 patients were rated as being excellent ,2 patients good, 1 fair and 1 poor, the total rate of being excellent and good was 75%. No postoperative avascular necrosis of the talar was seen on radiographies. [ Conclusion ] Operation through approach of internal or external malleolus osteotomy and absorbable scrow for fixation is a good method for treatment of complex talar body fracture.