新型后踝解剖锁定钢板治疗后踝骨折的临床疗效研究

Clinical efficacy of a new anatomic locking plate for posterior malleolus fracture

摘要:

目的： 探讨新型后踝解剖锁定钢板治疗后踝骨折的临床疗效。方法： 收集2017年9月至2018年12月于昆明医科大学第一附属医院骨科就诊的踝关节骨折（骨折均累及后踝，骨折块面积均≥25%）患者资料，共计22例，男14例，女8例，年龄21～57岁，平均年龄42.5岁。其中三踝骨折20例（AO分型B型11例，C型9例）；单纯后踝骨折2例。所有患者经3～7 d（平均5 d）消肿待皮纹出现后，行经后外侧入路切开复位新型后踝解剖锁定钢板内固定治疗。结果： 术后22位患者获11～25个月（平均16个月）随访。骨折愈合时间8～13周，平均为11.8周，无骨折延迟愈合及骨折不愈合，1例出现皮肤浅表感染，经换药后愈合。末次随访均未出现创伤性骨关节炎。所有患者采用美国足踝外科协会踝与后足功能标准评分评定治疗效果：优20例，良2例，优良率为100%，平均分为94.0分。结论： 新型后踝解剖锁定钢板治疗后踝骨折疗效好，可作为后踝骨折固定的一种较好选择。

Abstract:

Objective: To investigate the clinical effect of a new anatomic locking plate for posterior malleolus fracture. Methods: Data of 22 patients (male of 14 patients and female of 8 patients; age from 21-57 years old, average of 42.5 years old) with ankle fractures (all the fractures involved the posterior ankle and the fracture area≥25%) that were admitted to our hospital from September 2017 to December 2018 were collected, including 20 patients suffered trimalleolar fracture (11 patients with type AO and B, and 9 patients with type C) and 2 patients suffered posterior malleolus fracture. All patients were treated with open reduction via the posterolateral approach and internal fixation with a new posterior malleolus anatomical locking plate after 3 days to 7 days (mean 5 days) of deswelling until the appearance of dermatoglyphic lines. Results: After operation, 22 patients were followed up for 11 to 25 months (mean 16 months). The fracture healing time was 8 to 13 weeks, with an average of 11.8 weeks. There was no fracture delay healing and fracture non-healing. One patient had superficial skin infection, which was healed after dressing change. No traumatic osteaorthritis was occurred at the last follow-up. All patients were evaluated with the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale: excellent 20 cases and good 2 cases, with excellent and good rate of 100% and average score of 94.0 points. Conclusion: The new anatomic locking plate of posterior malleolus has a good curative effect and is a good choice for fixing posterior malleolus fracture.