中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (22): 4056-4060.doi: 10.3969/j.issn.1673-8225.2011.22.016

• 骨科植入物 orthopedic implant • 上一篇    下一篇

后踝骨折切开复位螺钉置入过程中直视观察法与X射线透视法的比较

张国柱，蒋协远   

  1. 北京积水潭医院创伤骨科，北京市  100035
  • 收稿日期:2010-11-04 修回日期:2011-05-16 出版日期:2011-05-28 发布日期:2011-05-28
  • 作者简介:张国柱★，男，1967年生，北京市人，汉族，1991年北京医科大学毕业，硕士，副主任医师，主要从事骨创伤的研究。 kd1230785@sina.com

Direct vision versus roentgenoscopy during screw fixation of the posterior malleolar fragment

Zhang Guo-zhu, Jiang Xie-yuan   

  1. Department of Orthorpaedic Trauma, Beijing Jishuitan Hospital, Beijing  100035, China
  • Received:2010-11-04 Revised:2011-05-16 Online:2011-05-28 Published:2011-05-28
  • About author:Zhang Guo-zhu★, Master, Associate chief physician, Department of Orthorpaedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China kd1230785@sina.com

PDF

356

被引次数

14

摘要：

背景：既往后踝骨折的复位与固定过程中采用的传统X射线透视观察法，内踝脱位法及外踝截骨法等都存在不同程度的不满意之处。直视观察法可从另一种途径提供观察隐蔽的后踝。
目的：观察在后踝骨折切开复位螺钉置入过程中直视观察法与X射线透视法的优劣。
方法：选择2006-01/12北京积水潭医院创伤骨科收治的踝关节骨折患者26例，按照性别、年龄、骨折类型、受伤至手术时间等分为2组，每组13例。X射线透视组采用传统X射线透视法观察后踝骨折复位固定情况，直视组组采用直视法。
结果与结论：直视组随访时间17~29个月，平均23个月；X射线透视组17~28个月，平均22.5个月。所有病例均获得骨性愈合，后踝关节面复位良好。直视组后踝复位及固定时间平均(8.08±1.55) min；X射线透视组平均(20.15±4.22) min，差异有显著性意义(P < 0.01)。直视组平均术中后踝X射线透视1次；X射线透视组为3~8次，平均(5.38±1.76)次，差异有显著性意义(P < 0.01)。直视组和X射线透视组AOFAS评分均为86~100分，平均96分，其中优各11例，良各2例。提示直视法观察后踝骨折复位及固定情况优于传统X射线透视法。

关键词: 后踝骨折, X射线透视, 直视法, 螺钉置入, 内固定

Abstract:

BACKGROUND: Previously, the roentgenoscopy, medial malleolus dislocation and lateral malleolus osteotomy often used in reduction and fixation of posterior malleolar fractures are dissatisfied to different extents. Direct vision method can provide an alternative way to observe the posterior malleolus.
OBJECTIVE: To compare the direct vision and roentgenoscopy during screw fixation of the posterior malleolar fractures.
METHODS: Twenty-six patients with posterior malleolar fractures were selected from Beijing Jishuitan Hospital between January 2006 and December 2006. The patients were divided into two groups according to sex, age, fracture type, time from injury to operation, and 13 cases were in each group. Roentgenoscopy group received the roentgenoscopy to observe the reduction and fixation of the posterior malleolar fragments, and direct vision group underwent direct vision.
RESULTS AND CONCLUSION: The average time of follow-up was 23 (17-29) months in the direct vision group and 22.5 (17-28) months in the roentgenoscopy group. All the 26 cases had bone union wth the anatomic reduction of the posterior malleolar fragments. The time for reduction and fixation of posterior malleolar fractures was (8.08±1.55) minutes in the direct vision group and (20.15±4.22) minutes in the roentgenoscopy group (P < 0.01). There was a significant difference in the number of x-ray fluoroscopy between the direct vision group (3-8 times) and roentgenoscopy group (once) (P < 0.01). The AOFAS scores were 86-100, 96 on average, in both two groups, including 11 excellent cases and 2 good cases. It is indicated that the direct vision method is superior to the roentgenoscopy.

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