Objective To investigate the therapeutic effect of lengthening and rotational osteotomy of the fibula for lateral malleolar malunion.Methods Twenty-three patients who suffered from the traumatic arthritis of ankle wer...Objective To investigate the therapeutic effect of lengthening and rotational osteotomy of the fibula for lateral malleolar malunion.Methods Twenty-three patients who suffered from the traumatic arthritis of ankle were due to展开更多
Isolated distal fibula fractures represent the majority of ankle fractures.These fractures are often the result of a low-energy trauma with external rotation and supination mechanism.Diagnosis is based on clinical sig...Isolated distal fibula fractures represent the majority of ankle fractures.These fractures are often the result of a low-energy trauma with external rotation and supination mechanism.Diagnosis is based on clinical signs and radiographic exam.Stress X-rays have a role in detecting associated mortise instability.Management depends on fracture type,displacement and associated ankle instability.For simple,minimally displaced fractures without ankle instability,conservative treatment leads to excellent results.Conservative treatment must also be considered in overaged unhealthy patients,even in unstable fractures.Surgical treatment is indicated when fracture or ankle instability are present,with several techniques described.Outcome is excellent in most cases.Complications regarding wound healing are frequent,especially with plate fixation,whereas other complications are uncommon.展开更多
目的探讨腓骨近端骨折对累及后外侧髁的复杂胫骨平台骨折手术预后的影响。方法回顾性分析自2014年1月至2019年12月,我院收治的累及后外侧髁的胫骨平台SchatzkerⅣ、Ⅴ、Ⅵ型骨折接受手术治疗的患者118例,其中男60例,女58例;年龄18~75岁...目的探讨腓骨近端骨折对累及后外侧髁的复杂胫骨平台骨折手术预后的影响。方法回顾性分析自2014年1月至2019年12月,我院收治的累及后外侧髁的胫骨平台SchatzkerⅣ、Ⅴ、Ⅵ型骨折接受手术治疗的患者118例,其中男60例,女58例;年龄18~75岁,平均年龄(51.8±10.6)岁。按有无腓骨近端骨折和后外侧支撑钢板固定分为A1、A2和B1、B2组,A1组无腓骨近端骨折但有后外侧支撑钢板固定,共30例;A2组无腓骨近端骨折也无后外侧支撑钢板固定,共32例;B1组有腓骨近端骨折又有后外侧支撑钢板固定,共28例;B2组有腓骨近端骨折但无后外侧支撑钢板固定,共28例。对A1、A2和B1、B2组间患者的手术时间、术中出血量、胫骨平台内翻角(tibial plateau angle,TPA)、胫骨平台后倾角(posterior slope angle,PA)及美国特种外科医院(hospital for special surgery,HSS)膝关节评分优良率进行比较。结果118例患者均获随访,随访时间12~16个月,平均(13.2±1.5)个月。末次随访时,A1组与A2组的TPA、PA及HSS膝关节评分优良率比较,差异均无统计学意义(P>0.05);B1组与B2组的手术时间、出血量及末次随访TPA、PA、HSS膝关节评分优良率比较,差异均有统计学意义(P<0.05)。118例均无感染、内固定松动或断裂及腓总神经损伤。结论合并腓骨近端骨折累及后外侧髁的胫骨平台SchatzkerⅣ、Ⅴ、Ⅵ型骨折患者,手术中进行后外侧支撑钢板固定能更有效地减少继发性复位丢失,获得更好的预后。展开更多
文摘Objective To investigate the therapeutic effect of lengthening and rotational osteotomy of the fibula for lateral malleolar malunion.Methods Twenty-three patients who suffered from the traumatic arthritis of ankle were due to
文摘Isolated distal fibula fractures represent the majority of ankle fractures.These fractures are often the result of a low-energy trauma with external rotation and supination mechanism.Diagnosis is based on clinical signs and radiographic exam.Stress X-rays have a role in detecting associated mortise instability.Management depends on fracture type,displacement and associated ankle instability.For simple,minimally displaced fractures without ankle instability,conservative treatment leads to excellent results.Conservative treatment must also be considered in overaged unhealthy patients,even in unstable fractures.Surgical treatment is indicated when fracture or ankle instability are present,with several techniques described.Outcome is excellent in most cases.Complications regarding wound healing are frequent,especially with plate fixation,whereas other complications are uncommon.
文摘目的探讨腓骨近端骨折对累及后外侧髁的复杂胫骨平台骨折手术预后的影响。方法回顾性分析自2014年1月至2019年12月,我院收治的累及后外侧髁的胫骨平台SchatzkerⅣ、Ⅴ、Ⅵ型骨折接受手术治疗的患者118例,其中男60例,女58例;年龄18~75岁,平均年龄(51.8±10.6)岁。按有无腓骨近端骨折和后外侧支撑钢板固定分为A1、A2和B1、B2组,A1组无腓骨近端骨折但有后外侧支撑钢板固定,共30例;A2组无腓骨近端骨折也无后外侧支撑钢板固定,共32例;B1组有腓骨近端骨折又有后外侧支撑钢板固定,共28例;B2组有腓骨近端骨折但无后外侧支撑钢板固定,共28例。对A1、A2和B1、B2组间患者的手术时间、术中出血量、胫骨平台内翻角(tibial plateau angle,TPA)、胫骨平台后倾角(posterior slope angle,PA)及美国特种外科医院(hospital for special surgery,HSS)膝关节评分优良率进行比较。结果118例患者均获随访,随访时间12~16个月,平均(13.2±1.5)个月。末次随访时,A1组与A2组的TPA、PA及HSS膝关节评分优良率比较,差异均无统计学意义(P>0.05);B1组与B2组的手术时间、出血量及末次随访TPA、PA、HSS膝关节评分优良率比较,差异均有统计学意义(P<0.05)。118例均无感染、内固定松动或断裂及腓总神经损伤。结论合并腓骨近端骨折累及后外侧髁的胫骨平台SchatzkerⅣ、Ⅴ、Ⅵ型骨折患者,手术中进行后外侧支撑钢板固定能更有效地减少继发性复位丢失,获得更好的预后。