微型接骨板治疗隐匿性楔舟关节损伤的疗效

Curative effect of mini-plate treatment on occult navicular-cuneiform damage

目的探讨隐匿性楔舟关节损伤的治疗方法及疗效。方法选择武警后勤学院附属医院2007年6月至2012年12月收治的34例隐匿性楔舟关节损伤患者,男22例,女12例,其中车祸伤16例,机器绞伤15例,高处坠落伤3例,均行切开复位微型钢板螺丝钉内固定术,对其预后进行评价分析。结果术后32例切口Ⅰ期愈合,2例经换药后愈合。所有患者均得到随访,随访时间9~36个月。均无骨筋膜室综合征、骨不连、内固定物松动或断裂等并发症发生。术后4例行走时自觉患足不适及轻微疼痛,2例有轻度创伤性关节炎,经休息后可缓解。按照美国矫形足踝协会标准评价足功能,优20例,良8例,可4例,差2例。结论微型接骨板治疗楔舟关节骨折脱位治疗效果好。

Objective To investigate the curative effect of mini-plate treatments on occult navicular-cuneiform damage. Methods A total of 34 patients with navicular-cuneiform fracture-dislocation were treated in the Affiliated Hospital of Chinese People＇s Armed Police Force Logistics College from June 2007 to December 2012,with 22 male and 12 female. Injury was caused by a machine in 15 cases,by traffic accident in 16 cases and by falling from height in 3 cases. All cases were treated with open reduction and internal fixation. Prognosis of the patients was evaluated and analyzed. Results Incision healed by first intention in other patients except 2 patients who had effusion at incision. All cases were followed up for 9- 36 months. No complication was found,such as osteofascial compartment syndrome,nonunion infection,loosening or fracture of the internal fixator. Four patients felt discomfortable when walking and two had mild traumatic arthritis at 6 months after the operation. According to American Orthopaedic Foot and Ankle Society midfoot scoring,20 cases were excellent,8 cases were good,4 cases were fair and 2 cases were bad. Conclusion The therapy for navicular-cuneiform fracture-dislocation with mini-plate could be approved to achieve a good clinical result.