开放距骨骨折脱位的手术治疗效果

The effect of operation for open fracture and dislocation of the talus

目的：探讨开放距骨骨折脱位的手术治疗效果。方法手术治疗21例开放距骨骨折患者,其中克氏针固定3例,螺钉辅以克氏针短期固定5例,空心拉力螺钉固定13例。6例患者取自体髂骨植骨,15例一期缝合,6例一期负压封闭引流。10例术后再次清创,其中8例行皮瓣覆盖,2例植皮。结果21例均获随访,时间12~48个月。采用美国足踝外科协会（ AOFAS）踝与后足评分评价：优10例,良8例,可2例,差1例。结论开放距骨骨折脱位应急诊手术,利用原伤口或再辅助切口进行复位固定,可获得满意疗效。

Objective To investigate the effect of operation of open fractures of the talar dislocation. Methods There are 21 cases of open talus fracture patients. Kirschner wire fixation was used in 3 patients, screws and Kir-schner wire fixation was used in 5 patients, cannulated screw fixation was used in 13 patients,and 6 patients were grafted by autogenous iliac. Fifteen cases obtained primary suture, VSD drainage was used in 6 cases. Debridement after surgery occurred in 10 cases, among them, 8 cases of flap coverage, and 2 cases of skin grafts. Results All patients were followed up for 12~48 months. According to the ankle and hindfoot score standards of the American Orthopaedic Foot and Ankle Society adopted （AOFAS）：the results were excellent in 10 cases, good in 8, fair in 2 and poor in 1. Conclusions The emergency operation should be applied in open talus fracture-dislocation,and it can obtain satisfactory results.