50例距骨骨折的疗效分析

The analysis of therapeutic effect for the talus fracture in 50 cases

目的:回顾性分析50例距骨骨折患者的特点、类型、手术方法及影响疗效的相关因素。方法:2003年3月～2010年3月,本科共治疗距骨骨折患者50例,根据Hawkins分型方法,Ⅰ型骨折8例,Ⅱ型骨折26例,Ⅲ型骨折16例。采用手法复位石膏外固定或切开复位2枚螺钉内固定,术后短腿管形石膏外固定6～8周,X线片示骨折线模糊后拆石膏行不负重下踝关节活动,骨折线消失后恢复伤前活动。结果:所有患者均获得随访。随访时间为2.5～4.0年,平均3年。根据Hawkins疗效标准判定,优17例(34%),良24例(48%),可7例(14%),差2例(4%),优良率为82%。结论:距骨骨折并发症多且后果严重,但通过早期解剖复位、有效内固定、辅助功能锻炼等综合治疗,可最大限度地恢复患者的足部功能。

Objective： To retrospective analysis of 50 cases of the characteristics of talus fracture, type, surgical methods and factors influencing efficacy. Methods： From March 2003 to March 2010, the division talus fractures were treated 50 patients, according to Hawkins typing method, Ⅰ fracture in 8 cases, Ⅱ fracture of 26 cases, Ⅲ fractures in 16 cases. With manipulative reduction and external fixation or open reduction and plaster two screw fixation and postoperative short leg plaster cast fixation 6 to 8 weeks, X ray showed the fracture line blurred the line after the demolition of plaster under the ankle joint was not weight-bearing activities, the fracture line recovery after injury disappeared before the activity. Results： All patients were followed up. Follow-up time was 2.5 to 4.0 years, an average of 3 years. Determine the efficacy of the standard according to Hawkins, excellent in 17 cases （34%）, good in 24 cases （48%） in 7 cases （14%）, poor in 2 cases （4%）, good rate of 82%. Conclusion： Complications of talus fractures and more serious consequences, but by early anatomical reduction, and effective internal fixation, accessibility training and other comprehensive treatment to maximize recovery of patients with foot function.