空心加压螺钉联合钢板内固定治疗距骨颈骨折

Treatment of Talar Neck Fracture with Hollow Pressure Screw and Plate Stabilization

目的探讨采用空心加压螺钉联合钢板内固定技术,治疗距骨颈骨折的临床疗效。方法2007年3月至2010年8月,应用空心加压螺钉联合钢板内固定技术,治疗24例闭合距骨颈骨折患者。男15例,女9例;年龄19～52岁(平均35.3岁)。所有患者均采取内外侧联合入路。观察术后骨折复位情况、术后并发症的发生,以及术后功能恢复情况。结果24例患者术后均获随访,随访时间2～4年(平均2.7年)。术后切口均Ⅰ期愈合,23例患者距骨骨折获得愈合,1例患者出现骨折不愈合。未出现切口感染、皮肤坏死等术后并发症。发生创伤性踝关节炎2例,距骨下关节创伤性关节炎3例。按Hawkins疗效评价标准,本组患者优11例,良8例,可3例,差2例,优良率为79.2%。结论空心加压螺钉联合钢板内固定治疗距骨颈骨折,可使骨折固定更加坚固,骨折可获得解剖复位,术后并发症少,临床治疗效果满意,是治疗距骨颈骨折的有效方法。

Objective To evaluate the effects of hollow pressure screw with plate stabilization in treatment of talar neck fracture. Methods From Mar. 2007-Aug. 2010, 24 cases with talar neck fracture were treated by this method. There were 15 males and 9 females with an average age of 35.3 years （range, 19-52）. Results All cases were followed up 2-4 years （mean 2.7 years）. The healing of first intension was achived in all aeses. Fracture healing was achived in 23 cases except for 1 case. Complications such as infection, skin necrosis were not observed. According to Hawkings criterion, the excellent and good rate was 79.2% （excellent in 11 cases, good in 8 cases）. Conclusion The hollow pressure screw with plate stabilization in treatment of talar neck fracture can provide strong fixation, obotain anatomical reduction, enhance fracture healing and decrease complications.