摘要
目的 探讨老年患者不同形态的后踝骨折块对无头加压空心钉微创治疗的疗效影响。方法 回顾性分析2017年3月—2020年4月四川省骨科医院老年骨科收治的73例累及后踝的踝关节骨折患者资料,男性30例,女性43例;年龄70~89岁,平均78.1岁。均为扭伤或跌倒等致踝关节骨折,且Lauge-Hanse分型中旋后-外旋、旋前-外旋累及后踝,均行微创无头加压空心钉治疗,按后踝骨折块的直径、高度、面积分组,在术后3、6、12个月采用美国足踝外科学会(AOFAS)评分评价疗效。结果 患者随访12~17个月,平均14.0个月。骨折均骨性愈合。术后3、6、12个月时,老年后踝骨折块直径<25%与≥25%组,AOFAS评分比较差异无统计学意义(P>0.05)。术后3、6、12个月时,后踝骨折块高度<19.7mm组较≥19.7mm组的AOFAS评分更高(P<0.05);术后3、6个月时,后踝骨折块面积<25%组较≥25%组的患者AOFAS评分更高(P<0.05),术后12个月时两组不同面积的后踝骨折块患者AOFAS评分比较差异无统计学意义(P>0.05)。结论 微创无头加压空心钉治疗老年患者后踝骨折中,后踝骨折块高度影响其疗效,后踝骨折块高度<19.7mm时术后功能恢复更佳;术后1年,后踝骨折块的面积对疗效无影响。
Objective To investigate the effect of different shapes of posterior malleolus fracture block on minimally invasive treatment of headless compression cannulated screw in elderly patients.Methods The data of 73 patients with ankle fracture involving the posterior ankle treated in the Department of Geriatric Orthopedics of Sichuan Orthopedic Hospital from Mar.2017 to Apr.2020 were analyzed retrospectively.There were 30 males and 43 females,with an average age of 78.1 years(range,70 to 89 years).The patients with ankle fracture caused by sprain or fall,and supination external rotation and pronation external rotation in Lauge-Hanse classification involving the posterior malleolus were all treated with minimally invasive headless compression cannulated screw.They were grouped according to the diameter,height and area of the posterior malleolus fracture block.The curative effect was evaluated by the American Society of Foot and Ankle Surgery(AOFAS)at 3 months,6 months and 1 year after operation.Results The patients were followed up for 12-17 months,with an average of 14.0 months.All fractures healed.At 3 months,6 months and 1 year after operation,the AOFAS score of elderly patients with posterior ankle fracture block height<19.7mm was higher than that of elderly patients with posterior ankle fracture block height≥19.7mm(P<0.05).At 3 months and 6 months after operation,the AOFAS score of elderly patients in the group with posterior ankle fracture block area<25%was higher than that in the group with posterior ankle fracture block area≥25%(P<0.05).At 1 year after operation,there was no significant difference in AOFAS score between the two groups(P>0.05);At 3 months,6 months after operation,AOFAS score with the diameter of posterior ankle fracture less than 25%was higher than that of≥25%(P>0.05).Conclusion In the treatment of posterior ankle fracture of elderly patients with minimally invasive headless compression cannulated screw,the postoperative functional recovery is better when the height of posterior ankle fracture block is less than 19.7mm,and the height of posterior ankle fracture block affects its curative effect.At 1 year after operation,the area of posterior ankle fracture block has no effect on the efficacy of minimally invasive headless compression cannulated screw in the treatment of posterior ankle fracture.
作者
李峰
乐劲涛
贾军锋
蒋柒
潘汝南
秦谊
唐承杰
Li Feng;Le Jintao;Jia Junfeng;Jiang Qi;Pan Runan;Qin Yi;Tang Chengjie(Section II,Department of Geriatric Orthopaedics,Sichuan Orthopaedics Hospital,Chengdu 610041,China;Wenjiang People's Hospital,Chengdu 610041,China)
出处
《创伤外科杂志》
2022年第5期352-356,共5页
Journal of Traumatic Surgery
关键词
后踝骨折
空心钉
老年
影像学
posterior malleolus fracture
cannulated screw
elderly
imaging
