经皮锁定钢板结合空心钉治疗Ⅲ、Ⅳ型张-侯氏骨折

Percutaneous Locking Plate Combined with Cannulated Screws for Treatment of Type Ⅲ、Ⅳ Z-H fractures

目的：探讨采用闭合复位经皮锁定钢板结合空心钉治疗Ⅲ、Ⅳ型张-侯氏骨折疗效.方法：自2013年3月～2014年9月,我们应用经皮锁定钢板结合空心钉治疗张-侯氏骨折33例,其中Ⅲ型骨折19例,Ⅳ型骨折14例.结果：全部病例获得随访7 ～ 22个月（平均19个月）所有病例获得骨性愈合,功能恢复满意.按照Kofoed踝关节评分标准,优28例,良3例,及格2例,差0例,优良率达到93.94％.结论：经皮锁定钢板结合空心钉治疗Ⅲ、Ⅳ型张-侯氏骨折,固定可靠,可早期活动进行功能锻炼,降低踝关节创伤性关节炎,踝关节僵硬等并发症的发生率,能够较好地恢复患肢功能,取得了较好的治疗效果.

Objective：To explore the clinical results of treatment of Type Ⅲ,Ⅳ Z -H fracture by closed reduction with pereutaneous locking plate combined with cannulated screws. Methods： A total of 33 patients （including 19 Type Ⅲ and 14 Type Ⅳ Z -H fractures） were treated by closed reduction with percutaneous locking plate combined with cannulated screws, from Marc. 2013 to Sept. 2014 . Results： Followed up for 7 -22 months（ average 19 months） ,all of 33 fractures were healed and function satisfied. According to Kofoed ankle function score, the results were rated as excellent in 28 cases, good in 3 cases, moderate in 2, and poor in 0 cases, with the good - excellent rate being 93.94%. Conclusion： Fixation with percutaneous locking plate combined with cannulated screws is a good method to treat the Z - H fracture, which is stable enough and can make early mabi]ization and less complications such as traumatic arthritis and stiffness of ankle joint be possible.