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-  2015 

累及Tillaux-Chaput骨块的成人踝关节骨折临床特点及手术疗效

DOI: doi:10.7507/1002-1892.20150062

Keywords: 踝关节骨折, Tillaux-Chaput骨折, 切开复位内固定

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Abstract:

目的探讨累及Tillaux-Chaput骨块的成人踝关节骨折的临床特点及手术疗效。 方法回顾分析2009年5月-2013年5月,采用切开复位内固定术治疗的15例累及Tillaux-Chaput骨块的成人踝关节骨折患者临床资料。男12例,女3例;年龄19~45岁,平均32岁。致伤原因:运动损伤8例,交通事故伤5例,高处坠落伤2例。左侧5例,右侧10例;其中2例为开放骨折(GustiloⅠ型),13例闭合骨折;单独Tillaux-Chaput撕脱骨折5例。骨折根据Lauge-Hansen分型,旋后外旋型9例,旋前外旋型5例,旋前外展型1例。受伤至手术时间3 h~15 d,平均8.5 d。 结果术后2例患者切口发生皮肤浅层感染,经口服抗生素及换药后愈合;其余患者切口均Ⅰ期愈合,无感染及神经血管损伤等并发症发生。患者均获随访,随访时间13~36个月,平均23个月。X线片复查示,所有骨折均达骨性愈合,愈合时间10~16周,平均13周。术后1年,根据美国矫形足踝协会(AOFAS)踝与后足评分标准评价踝关节功能为78~99分,平均87分;获优9例,良3例,可3例,优良率达80%。 结论手术治疗累及Tillaux-Chaput骨块的成人踝关节骨折有利于患者踝关节功能恢复,可获得较好临床疗效

References

[1]  19. van den Bekerom MP, Raven EE. The distal fascicle of the anterior inferior tibiofibular ligament as a cause of tibiotalar impingement syndrome:a current concepts review. Knee Surg Sports Traumatol Arthrosc, 2007, 15(4):465-471.
[2]  20. Schlesinger I, Wedge JH. Percutaneous reduction and fixation of displaced juvenile Tillaux fractures:a new surgical technique. J Pediatr Orthop, 1993, 13(3):389-391.
[3]  21. Duchesneau S, Fallat LM. The tillaux fracture. J Foot Ankle Surg, 1996, 35(2):127-133.
[4]  22. Cooperman DR, Spiegel P, Laros G. Tibial fractures involving the ankle in children. The so-called triplane epiphyseal fracture. J Bone Joint Surg (Am), 1978, 60(8):1040-1046.
[5]  24. Oak NR, Sabb BJ, Kadakia AR, et al. Isolated adult tillaux fracture:a report of two cases. J Foot Ankle Surg, 2014, 53(4):489-492.
[6]  25. Jennings MM, Lagaay P, Schuberth JM. Arthroscopic assisted fixation of juvenile intra-articular epiphyseal ankle fractures. J Foot Ankle Surg, 2007, 46(5):376-386.
[7]  17. Ogilvie-Harris DJ, Reed SC, Hedman TP. Disruption of the ankle syndesmosis:biomechanical study of the ligamentous restraints. Arthroscopy, 1994, 10(5):558-560.
[8]  26. Ono A, Nishikawa S, Nagao A, et al. Arthroscopically assisted treatment of ankle fractures:arthroscopic findings and surgical outcomes. Arthroscopy, 2004, 20(6):627-631.
[9]  3. Kim JR, Song KH, Song KJ, et al. Treatment outcomes of triplane and Tillaux fractures of the ankle in adolescence. Clin Orthop Surg, 2010, 2(1):34-38.
[10]  6. Brown SD, Kasser JR, Zurakowski D, et al. Analysis of 51 tibial triplane fractures using CT with multiplanar reconstruction. AJR Am J Roentgenol, 2004, 183(5):1489-1495.
[11]  8. Gourineni P, Gupta A. Medial joint space widening of the ankle in displaced tillaux and triplane fractures in children. J Orthop Trauma, 2011, 25(10):608-611.
[12]  9. Hamilton WC. Traumatic disorders of the ankle. New York:Springer, 1984:293.
[13]  12. Yang Y, Zhou J, Li B, et al. Operative exploration and reduction of syndesmosis in Weber type C ankle injury. Acta Ortop Bras, 2013, 21(2):103-108.
[14]  14. Xu HL, Li X, Zhang DY, et al. A retrospective study of posterior malleolus fractures. Int Orthop, 2012, 36(9):1929-1936.
[15]  1. Court-Brown CM, Caesar B. Epidemiology of adult fractures:A review. Injury, 2006, 37(8):691-697.
[16]  2. Rosenbaum AJ, DiPreta JA, Uhl RL. Review of distal tibial epiphyseal transitional fractures. Orthopedics, 2012, 35(12):1046-1049.
[17]  4. Sharma B, Reddy IS, Meanock C. The adult Tillaux fracture:one not to miss. BMJ Case Reports, 2013, doi:10.1136/bcr-2013-200105.
[18]  5. Cutler L, Molloy A, Dhukuram V, et al. Do CT scans aid assessment of distal tibial physeal fractures? J Bone Joint Surg (Br), 2004, 86(2):239-243.
[19]  7. Goost H, Wimmer MD, Barg A, et al. Fractures of the ankle joint:investigation and treatment options. Deutsches ?rzteblatt International, 2014, 111(21):377-388.
[20]  10. Ramsey P, Hamilton W. Changes in tibiotalar area of contact caused by lateral talar shift. J Bone Joint Surg (Am), 1976, 58(3):356-357.
[21]  11. Thordarson DB, Motamed S, Hedman T, et al. The effect of fibular malreduction on contact pressures in an ankle fracture malunion model. J Bone Joint Surg (Am), 1997, 79(12):1809-1815.
[22]  13. Langenhuijsen JF, Heetveld MJ, Ultee JM, et al. Results of ankle fractures with involvement of the posterior tibial margin. J Trauma, 2002, 53(1):55-60.
[23]  15. Papachristou G, Efstathopoulos N, Levidiotis C, et al. Early weight bearing after posterior malleolar fractures:an experimental and prospective clinical study. J Foot Ankle Surg, 2003, 42(2):99-104.
[24]  16. Hermans JJ, Beumer A, Hop WC, et al. Tibiofibular syndesmosis in acute ankle fractures:additional value of an oblique MR image plane. Skeletal Radiol, 2012, 41(2):193-202.
[25]  18. Candal-Couto JJ, Burrow D, Bromage S, et al. Instability of the tibio-fibular syndesmosis:have we been pulling in the wrong direction? Injury, 2004, 35(8):814-818.
[26]  23. Kumar N, Prasad M. Tillaux fracture of the ankle in an adult:a rare injury. J Foot Ankle Surg, 2014, 53(6):757-758.

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