胫骨下1/3螺旋形骨折合并后踝骨折的治疗方法及临床效果研究

Study on the treatment and clinical effect of distal 1/3 spiral tibial fracture combined with posterior malleolar fracture

目的探讨胫骨下1/3螺旋形骨折合并后踝骨折的治疗方法及临床效果。方法回顾性分析9例胫骨下1/3螺旋形骨折合并后踝骨折患者的临床效果,观察患者愈合情况、并发症发生情况及治疗效果。结果所有患者均获随访,随访时间6~30个月,平均随访时间15个月。1例患者术后切口局部感染,经抗炎及加强换药后愈合;所有患者均甲级愈合。无骨髓炎、内固定松动或断裂、骨折再移位等并发症发生。所有患者均骨性愈合。优7例,良2例,优良率为100.0%。结论胫骨下1/3螺旋形骨折常合并后踝骨折,X线容易漏诊,根据病情行CT检查,必要时行磁共振成像(MRI)检查,可以有效避免漏诊。根据骨折情况选择有效方法治疗胫骨下1/3螺旋形骨折合并后踝骨折,创伤小,操作简单,并发症少,值得推广。

Objective To discuss the treatment and clinical effect of distal 1/3 spiral tibial fracture combined with posterior malleolar fracture.Methods The clinical effect of 9 patients with distal 1/3 spiral tibial fracture and posterior malleolar fracture was analyzed retrospectively,and the healing,complications and therapeutic effect of the patients were observed.Results All patients were followed up for 6-30 months,with an average follow-up time of 15 months.1 patient developed local incision infection after surgery,which healed after anti-inflammatory and intensive dressing change.All patients had grade A healing.No complications such as osteomyelitis,loosening or fracture of internal fixation,or redisplacement of fracture occurred.Bone healing was observed in all patients.7 cases were excellent,2 cases were good,and the excellent and good rate was 100.0%.Conclusion Distal 1/3 spiral tibial fracture is often combined with posterior malleolar fracture,which is easy to be missed by X-ray.CT and,if necessary,magnetic resonance imaging(MRI)examination can effectively avoid missed diagnosis.According to the fracture situation,the effective method is selected to treat distal 1/3 spiral tibial fracture combined with the posterior malleolus fracture,which has less trauma,simple operation and few complications,and is worth promoting.