一种新型撕脱性骨折固定装置在踝关节周围撕脱性骨折手术治疗中的应用*

目的评估一种新型撕脱性骨折固定装置固定踝关节周围撕脱性骨折的临床疗效。方法 2019年1月至2020年4月，以一种新型撕脱性骨折固定装置固定踝关节周围撕脱性骨折18例，其中男12例、女6例。按照Lauge-Hansen分型，旋后内收型4例，旋后外旋型9例，旋前外旋型5例。撕脱性骨折固定装置用于固定内踝撕脱性骨折13例，用于固定外踝撕脱性骨折5例。术后进行随访，随访满1年者按照AOFAS踝-后足评分系统行踝关节功能评定并记录并发症。结果 18例患者随访12 ～ 27个月，骨折均I期愈合，末次随访AOFAS踝-后足评分93.6分（80 ～ 100分）。1例内踝骨折患者和1例外踝骨折患者偶感内/外踝轻微刺痛，1例内踝骨折患者和1例外踝骨折患者感长距离行走后内/外踝轻微疼痛，行内固定取出术。结论新型撕脱性骨折固定装置固定踝关节周围撕脱性骨折有固定稳定、软组织友好的特点，可作为踝关节周围撕脱性骨折固定的一种选择。

英文摘要:

Objective To evaluate the clinical efficacy of fixation of periarticular avulsion fractures of the ankle using a new device for fixation of avulsion fractures. Methods From January 2019 to April 2020, a new device for fixation of avulsion fractures was used for fixation of periarticular avulsion fractures of the ankle in 18 patients, including 12 males and 6 females. According to Lauge-Hansen classification, there were 4 cases of supination adduction fractures, 9 cases of supination external rotation fractures and 5 cases of pronation external rotation fractures. The new device for fixation of avulsion fractures was used for fixation of medial malleolus avulsion fractures in 13 cases, and for fixation of lateral malleolus avulsion fractures in 5 cases. All the patients were followed-up postoperatively. The functional outcome was evaluated using AOFAS ankle-hind foot scale, and complications were recorded for those with more than 1 year follow-up. Results The 18 patients were followed-up for 12 to 27 months, and primary bone healing was achieved in all the 18 patients.The average AOFAS ankle-hind foot scale was 93.6 (80-100)scores at the last follow-up. Mild stabbing pain at the injured site was felt occasionally in 1 patient with medial malleolus fracture and 1 patient with lateral malleolus fracture, and mild pain at the injured site was felt after a long walk in 1 patient with medial malleolus fracture and 1 patient with lateral malleolus fracture.Internal fixation was removed in all 4 patients. Conclusion It is characterized by good stability and soft tissue friendly for fixation of periarticular avulsion fractures of the ankle using the new device for fixation of avulsion fractures, which can be considered an alternative for fixation of periarticular avulsion fractures of the ankle.

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