Chomiak J, Slavík M, Soukup B, Kolman J, Vavron P, Lichtenberg M
Ortopedická klinika ILF, Praha.
Acta Chir Orthop Traumatol Cech. 1990 Jun;57(3):224-37.
The authors have made evaluation of the surgical treatment of luxation fractures of the ankle in the period 1979-1987 in 105 patients (60 female, 45 male patients) in the age range from seventeen to eighty-one years, with the most frequent representation of the age group ranging from thirty-five to forty-five years. The group comprised 2,70 percent of fractures of type Weber A, 31.53 percent of fractures of type Weber B and 65.77 percent of fractures of type Weber C. 53 percent of patients were operated on the day of injury, 24.8 percent of patients were transferred with a delay from other clinics and in the rest of the patients the timely operation was contraindicated because of the poor local or general condition. The results were processed according to a uniform worksheet by the computer. On the basis of the evaluation there were found out 87.62 percent of successful and 12.38 percent of poor results. 93.3 percent of patients resumed their original jobs and there was no patient eligible for a full disability pension. The main cause of failure was the osteoarthritis of the ankle joint found out in connection with the inaffestable factors (such as defects of cartilage, nature of the bone lesion, luxation of talus, age and sex of the patient) and affectable factors (infection, failure of osteosynthesis, pseudoarthrosis of medial malleolus, non-anatomical position in the area of tibiofibular syndesmosis). The incidence of these negative factors may be reduced by a timely operation, precise surgical strategy and technique and proper post-operative treatment.
作者对1979年至1987年间105例踝关节脱位骨折患者(60例女性,45例男性)进行了手术治疗评估,患者年龄在17岁至81岁之间,年龄组最常见的范围是35岁至45岁。该组中,Weber A型骨折占2.70%,Weber B型骨折占31.53%,Weber C型骨折占65.77%。53%的患者在受伤当天接受手术,24.8%的患者从其他诊所延迟转诊,其余患者因局部或全身状况不佳而禁忌及时手术。结果由计算机根据统一工作表进行处理。根据评估,发现87.62%的结果成功,12.38%的结果不佳。93.3%的患者恢复了原来的工作,没有患者符合完全残疾抚恤金的条件。失败的主要原因是与不可控因素(如软骨缺损、骨损伤性质、距骨脱位、患者年龄和性别)和可控因素(感染、骨合成失败、内踝假关节、胫腓联合区域的非解剖位置)相关的踝关节骨关节炎。通过及时手术、精确的手术策略和技术以及适当的术后治疗,可以降低这些负面因素的发生率。