Bellamy Jaime L, Keeling John J, Wenke Joseph, Hsu Joseph R
Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.
J Surg Orthop Adv. 2011 Spring;20(1):34-7.
This retrospective study investigated active duty soldiers with delayed definitive fixation of combat-related talus fractures. The authors predicted a longer delay to internal fixation and a correlation between the timing of fixation and development of osteonecrosis and posttraumatic arthritis. The Joint Theater Trauma Registry was queried by ICD-9 codes for talus fractures. Soldiers, ages 18 to 40, with talus fracture between 2001 and 2008 were included. Radiographs identified the injury type, Hawkins sign, osteonecrosis, and posttraumatic arthritis. Mean time to fixation was 12.9 days. Hawkins sign was observed in 59% of fractures at a mean of 7 weeks. No correlation was found between osteonecrosis or posttraumatic arthritis and open fractures, comminuted fractures, or timing of fixation. Average follow-up was 16 months. This case series has the longest mean time to fixation by more than threefold. There was no correlation of delayed timing of fixation and development of osteonecrosis or posttraumatic arthritis.
这项回顾性研究调查了现役军人中战伤性距骨骨折确定性固定延迟的情况。作者预计内固定延迟时间会更长，且固定时机与骨坏死及创伤后关节炎的发生之间存在关联。通过ICD - 9编码在联合战区创伤登记处查询距骨骨折情况。纳入了2001年至2008年间年龄在18至40岁的距骨骨折士兵。通过X线片确定损伤类型、霍金斯征、骨坏死及创伤后关节炎情况。平均固定时间为12.9天。59%的骨折在平均7周时观察到霍金斯征。未发现骨坏死或创伤后关节炎与开放性骨折、粉碎性骨折或固定时机之间存在关联。平均随访时间为16个月。该病例系列的平均固定时间最长，超过三倍。固定延迟时机与骨坏死或创伤后关节炎的发生无相关性。
