距骨骨折脱位15例诊治体会

Experience in the treatment of 15 cases of talar fracture and dislocation

采用手法结合手术及中药内脏外用的治疗方法,治疗距骨骨折脱位15例结果治愈9例，好转4例，未愈2例。认为首选手法整复符合距骨的解剖特点。合理的复位可减少再创伤。手法不成功者，采用手术内固定可补救手法复位的不足。早期采用活血祛瘀通络的中药熏洗及中后期内服补肾的中药，可促进足部的气血运行，有利于距骨血供的重建，可促进骨折愈合和功能恢复。

Fifteen cases of talar fracture and dislocation were treated by comprehensive therapies: manipulations, surgery and TCD applied both internallyand externally. The results were good in 9 cases, fair in 4 and poor in 2. It was suggested that the manipulative reduction accords with theanatomic characteristics of the talus and should be first selected, and that the rational reduction could decrease the secondary injury. In case offaiIed manipulations, surgical internal fixation could remedy the shortcoming of the manipulative reduction. Fumigation and washing with blood circulation-activating and blood-stasis-eliminating TCD in early stage and internal application of kidney-tonifying TCD in middle and late stages'could promote the circulation of qi and blood, benefit the revascularization of the talus and stimulate fracture healing and functionaI recovery.