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距骨畸形愈合和不愈合的手术治疗临床结果

Clinical outcomes of surgical treatment for talar malunions and nonunions.

作者信息

Chen Da-Wei, Li Bing, Yang Yun-Feng, Zhou Jia-Qian, Li Hai-Feng, Aubeeluck Ashwin, Yu Guang-Rong

机构信息

Department of Orthopaedic Surgery, Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, Shanghai 200065, China.

出版信息

Acta Ortop Bras. 2013 Jul;21(4):226-32. doi: 10.1590/S1413-78522013000400009.

DOI:10.1590/S1413-78522013000400009
PMID:24453674
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3862002/
Abstract

OBJECTIVE

To present our experiences of treating talar malunions and nonunions.

METHOD

Between January 2000 and September 2009, 26 patients with malunions or nonunions after talar fractures underwent surgical treatment according to different types of talar deformities. The treatment outcomes were evaluated using AOFAS ankle-hindfoot scale as well as plain radiographs.

RESULTS

20 patients were available for follow-up for 30 (range, 24 to 60) months. No wound healing problems or infections occurred and solid unions were achieved in all patients. Radiological unions were achieved at a mean time of 14 (range, 12 to 18) weeks. The mean time to complete weight-bearing was 16 (range, 14 to 20) weeks. The mean AOFAS score increased significantly from 36.2 (range, 27 to 43) to 85.8 (range, 74 to 98).

CONCLUSION

Surgical interventions for malunions and nonunions after talar fractures can bring about satisfactory outcomes, and the appropriate procedure should be adopted according to different types of posttraumatic deformities.

LEVEL OF EVIDENCE

IV, Retrospective Study.

摘要

目的

介绍我们治疗距骨畸形愈合和不愈合的经验。

方法

2000年1月至2009年9月期间，26例距骨骨折后畸形愈合或不愈合患者根据距骨畸形的不同类型接受了手术治疗。采用美国足踝外科协会（AOFAS）踝-后足评分量表以及X线平片对治疗结果进行评估。

结果

20例患者获得随访，随访时间为30个月（范围24至60个月）。所有患者均未出现伤口愈合问题或感染，均实现了牢固愈合。影像学愈合的平均时间为14周（范围12至18周）。完全负重的平均时间为16周（范围14至20周）。AOFAS平均评分从36.2分（范围27至43分）显著提高至85.8分（范围74至98分）。

结论

距骨骨折后畸形愈合和不愈合的手术干预可带来满意的结果，应根据不同类型的创伤后畸形采用适当的手术方法。

证据水平

IV级，回顾性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ef8/3862002/a43530fabc68/aob-21-226-g15.jpg
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Long-term follow-up after surgical treatment of talar fractures: Twenty cases with an average follow-up of 7.5 years.距骨骨折手术后的长期随访：20 例患者平均随访 7.5 年。
Int Orthop. 2011 Jan;35(1):93-9. doi: 10.1007/s00264-009-0930-y. Epub 2009 Dec 22.
3
Post talus neck fracture reconstruction.距骨颈骨折重建术后。
Foot Ankle Clin. 2007 Mar;12(1):137-51. doi: 10.1016/j.fcl.2006.12.006.
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The development of posttraumatic arthritis after articular fracture.关节骨折后创伤后关节炎的发展
J Orthop Trauma. 2006 Nov-Dec;20(10):719-25. doi: 10.1097/01.bot.0000211160.05864.14.
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Anatomical reconstruction of malunited talus fractures: a prospective study of 10 patients followed for 4 years.距骨骨折畸形愈合的解剖重建：一项对10例患者进行4年随访的前瞻性研究。
Acta Orthop. 2005 Aug;76(4):588-96. doi: 10.1080/17453670510041600.
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Delayed surgical treatment for neglected or mal-reduced talar fractures.对被忽视或复位不良的距骨骨折进行延迟手术治疗。
Int Orthop. 2005 Oct;29(5):326-9. doi: 10.1007/s00264-005-0675-1. Epub 2005 Aug 11.
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