舟骨瓣移位术治疗Ⅲ型距骨颈骨折及并发症防治

Navicular Flap Pedicled with Medial Anterior Malleolar Vessels Transposition Treats Marti—Weber Ⅲ Type Talus Neck Fracture

目的观察舟骨瓣移位术治疗Ⅲ型距骨颈骨折及对并发症防治的效果。方法Marti-Weber分型Ⅲ型的距骨颈骨折患者46例,按患者的意愿分为两组,舟骨瓣组28例,采用舟骨瓣移位术治疗;内固定组18例,采用"BIOFIX"可吸收螺钉和固定棒(芬兰)行内固定治疗。随访1～3年,评定两组疗效。结果所有患者无一例发生距骨缺血性坏死。治疗总有效率两组间差异无统计学意义(P>0.05)。结论舟骨瓣移位术与可吸收内固定术在Ⅲ型距骨颈骨折治疗效果和对并发症的防治方面无明显差别,但前者适用范围较广。

Objective To observe the effect of transposition of navicular flap pedicled with medial anterior malleolar vessels on Marti-Weber Ⅲ type talus neck fracture. Methods 46 cases with Marti-Weber Ⅲ type talus neck fracture were divided into two groups, navicular flap and internal fixation group,depending their wills. Patients in internal fixation group were treated with assimilate blots （Finland） ,those in navicnlar flap group with transposition of navicnlar flap pedicled with medial anterior malleolar vessels. Results The effect had not statistically significant difference between two groups （P〉 0.05） during 1-3 years follow up visit. And there was no Diaz disease. Conclusion Transposition of navicnlar flap pedicled with medial anterior malleolar vessels has the same therapeutic efficacy on Marti-Weber Ⅲtype talus neck fracture.