闭合复位经皮空心螺钉内固定选择性治疗踝关节骨折

Close Reduction and Percutaneous Internal Fixation with Hollow Screws for Selective Treatment of Fractures of Ankle Joint

目的探讨闭合复位经皮空心螺钉内固定选择性治疗踝关节骨折的手术方法、适应证及临床效果。方法回顾性分析2004年3月～2006年4月期间,采用闭合复位经皮空心拉力螺钉内固定治疗32例成人踝关节骨折的临床资料,其中旋后-外旋型19例,旋前-外旋型6例,旋前-外展型4例,旋后-内收型3例。结果平均随访25个月(17～42个月)。骨折愈合时间为8～15周。按美国足踝骨科协会(AOFAS)足踝评分系统评分,平均为92分(78～100分),优30例,可2例,优良率为93.8%。结论闭合复位经皮空心螺钉内固定是一种可用于选择性治疗踝关节骨折的微创术式,具有骨折愈合快,愈合率高,踝关节功能恢复满意的优点。

Objective To investigate the clinical results of dose reduction and pereutaneous internal fixation with hollow screws for selective treatment of fractures of ankle joint. Methods From March 2004 to April 2006, 32 patients with fractures of ankle joint were treated by this method. Nineteen cases had the supination- eversion fractures, 6 pronation- eversion fractures, 4 pronation- abduction fractures and 3 supination- assuetion fractures. Results The average follow - up was 25 months （ 17 -- 42 months）. The rate of fracture healing was 100 % and the healing time was 8 to 15 weeks. According to foot and ankle function scores recommended by American Orthopaedics of Foot and Ankle Society, the average score was 92 （78-100）. Thirty patients were excellent and 2 was fair. The excellent and good rate was 93.8 %. Conclusion Close reduction and percutaneous internal fixation with hollow screws was a minimal invasive surgery for some types of fractures of ankle joint with the satisfactory joint function and fracture healing rate.