闭合复位经皮微创内固定治疗内踝骨折

Treatment of medial malleolus fractures with closed reduction and percutaneous internal fixation

目的:探讨一种采用微创、有效、经济的手术方式治疗内踝骨折的临床疗效。方法:2008年3月至2010年8月,治疗内踝骨折19例,男12例,女7例;年龄17～42岁,平均31.7岁。内踝骨折经闭合复位后,分别采用1枚空心加压螺钉经骨折面中央并与其垂直置入,1枚克氏针过骨折面与内踝轴线一致斜行打入并过对侧骨皮质。术后通过Kaikkonen踝关节损伤功能评分与影像学检查进行疗效评定。结果:术后所有患者切口Ⅰ期愈合,均获随访,时间为6～30个月,平均18.7个月。均达骨性愈合,临床愈合时间2.6～3.8个月,平均3.2个月。按Kaikkonen功能评分,优5例,良10例,可3例,差1例。结论:闭合复位、空心加压螺钉和克氏针联合内固定治疗内踝骨折微创、恢复快及费用少。

Objective：To study clinical effects of minimally invasive,effective and economic operational method for the treatment of medial malleolus fractures. Methods：From March 2008 to August 2010,19 patients（12 males and 7 females,ranging in age from 17 to 42 years,averaged 31.7 years）with medial malleolus fractures were reviewed. Closed reduction and percutaneous internal fixation were applied,with a hollow compression screw inserted at the centre and perpendicularly to the fracture surface. A Kirschner wire was inserted through the cortical bone of opposite side and in accordance with the axis of inner malleolus. Postoperative therapeutic effect was evaluated by Kaikkonen sprained ankle scoring system and imageology examination. Results：All the patients got primary healing of incisions and were followed up,the duration ranged from 6 to 30 months,with an average of 18.7 months. All the patients obtained bone union. Clinical healing time ranged from 2.6 to 3.8 months,averaged 3.2 months. According to Kaikkonen scoring system,the results were rated as excellent in 5 cases,good in 10 cases,moderate in 3 cases,and poor in 1 case. Conclusion：It is a minimally invasive,effective and economic method to treat medial malleolus fractures by closed reduction and percutaneous internal fixation with hollow compression screw and Kirschner wire.