距骨损伤与距骨坏死及其治疗

目的　探讨距骨损伤对距骨缺血坏死的影响及其治疗方法。方法　本文通过 2 5例距骨重度骨折脱位、 3例距骨全脱位和 17例距骨周围脱位的治疗 ,并分别经平均 7年和 2年 5个月的随访观察 ,来分析三种不同类型的损伤对距骨缺血坏死的影响。结果　距骨重度骨折脱位和全脱位缺血坏死率和创伤性关节炎发生率达 10 0 % ,距骨周围脱位则无缺血坏死发生。作者比较重度距骨骨折脱位和全脱位采用切开复位内固定、距骨切除和关节融合术三种治疗方法的结果 ,仅融合术最为满意。结论　作者建议在距骨有发生缺血坏死高危损伤的病例 ,融合术应是首选的方法

Talus Injuries and Necrosis and Its Treatment

Objective To study the relationship between talus injuries and talus necrosis and methods of its treatment Methods To analysis 25 cases of sever talus fractures and dislocations, 3 cases of total talus dislocations,17 cases of peritalus dislocations, All the cases have been followed up for an average 7 years and 2 years plus 5 moths respectively Results The morbidity of necrosis and osteoarthoritis following trauma in severe talus fracture dislocations is 100% and no necrosis occurred in the case of peritalus talus dislocation Comparison of the results of treatment in the cases of necrosis of talus with three different methods (reduction and immobilization, total talus resection and arthrodesis) was made The satisfactory was obtained only in cases treated with arthrodesis Conclusion Arthrodesis should be considered at first in the treatment for severe talus fracture dislocations and total talus dislocations cases