踝关节后方隐匿性小片骨软骨撕脱骨折的临床诊治

Clinical diagnosis and treatment of occult small osteochondral avulsion fracture in posterior ankle joint

目的探讨踝关节后方隐匿性小片骨软骨撕脱骨折的发生机理、发病特点及治疗方法。方法对我院在2009年10月～2010年10月收治的5例踝关节后方隐匿性小片骨软骨撕脱骨折患者的临床诊疗资料进行回顾性分析。结果本组5例患者的临床症状全部于术后消失,术后1 w开始下地行走,出院后进行为期6个月～2年的随访,均未复发。结论踝关节后方隐匿性小片骨软骨撕脱骨折的早期临床表现特异性较低,X线平片及CT检查中的表现也较为隐匿,容易造成漏诊,应引起重视。目前对于该病保守治疗效果不明显,应进行手术治疗,治愈率及症状改善程度均较高。

Objective To discuss the occurrence mechanism, characteristics, and treatment methods of occult small osteochondral avulsion fracture in posterior ankle joint. Methods Retrospective analyses of clinical data was made in 5 cases of occult small osteochondral avulsion fracture in posterior ankle joint that received treatment in our hospital from October 2009 to October 2010. Results The clinical symptoms of all those patients disappeared after the operation. The patients began to walk 1 w after the operation. During the six - month to two - year follow - up period after their discharging, there was no recurrence. Conclusion The early clinical manifestation of occult small osteochondral avulsion fracture in posterior ankle joint is of low specificity, and the manifestation of X ray film and CT examination is occuh, which can lead to missed diagnosis and should be paid more attention. At present, the curative effect of expectant treatment of this disease is not obvious. Surgical operation should be carried out, and its recovery rate and degree of symptom improvement are quite high.