摘要
目的:探讨Dupuytren骨折的诊断和治疗.方法:20例患者中男14例,女6例;平均年龄32.8岁(19~65岁).左踝12例,右踝8例.扭伤14例,坠落伤3例,车祸伤3例.开放伤5例,闭合伤15例.明确诊断时间:2 h内13例,3 d内5例,7 d内2例.13例通过踝关节正侧位X线片确诊,5例在加摄小腿全长正侧位X线片后确诊,2例在行双踝外翻应力X线片对照检查后确诊.20例确诊患者均行腓骨解剖复位半管形钢板内固定,10例伴内踝骨折者在内踝复位后用松质骨螺钉或张力带固定,14例固定下胫腓联合.结果:通过对17例患者进行了1.3~6年(平均3.1年)的随访,根据Meyer和Kumler的踝关节功能评价标准,17例中优10例,良4例,一般2例,差1例(此例患者在2个月后踝关节正侧位X线片显示内踝踝穴增宽).结论:对于Dupuytren骨折,早期准确的诊断和正确的外科治疗是恢复踝关节良好功能的关键.
Objective:To study the diagnosis and treatment of Dupuytren fracture. Methods: There were 20 patients( 14 male ,6 female)with an average age of 32. 8 years (range from 19-65 years). Left ankle 12 cases and right ankle 8 cases;strain in 14 cases,falling injury in 3 ,traffic accident in 3 ;open injury in 5 and close injury in 15. The time from injury to diagnosis: 13 cases in 2 hours,5 in 3 days,2 in 7 days. 13 cases were diagnosed by anterior and lateral X-ray,5 cases were diagnosed by full tibiofibular anterior and lateral X-ray, 2 cases were diagnosed by contrast the bimalleolar stressing X-ray. All patients were treated with fibula open reducted anatomically and fixed by 1/3 tubular plate. 10 cases with internal malleolar fracture were fixed by lag screw or tension band after reduction,the syndesmosis in 14 cases were fixed. Results:17 cases were followedup from 1.3 to 6 years with an average of 3. 1 years. The clinical effect were evaluated according to the criteria of Meyer and Kumler, the excellent in 10 cases, good in 4, fair in 2, poor in 1 ( after 2 months, the patient' s ankle cave were lenient in anterior and lateral X-ray). Conclusion:Earlier, accurate diagnosis and surgical treatment for Dupuytren fracture is the key to recovery function of ankle joint.
出处
《中国骨伤》
CAS
2006年第4期196-198,共3页
China Journal of Orthopaedics and Traumatology