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距骨体部和颈部骨折的长期结果

LONG-TERM RESULTS OF BODY AND NECK TALUS FRACTURES.

作者信息

Gomes de Sousa Ricardo Jorge, Teixeira de Oliveira Massada Marta Maria, Gonçalves Pereira Manuel Alexandre Negrais Pinho, Gonçalves Costa Isabel Maria, da Costa E Castro José Fernando Souzellas

机构信息

Complementary Intern, Orthopedic Clinic, Hospital de Santo Antonio, Porto, Portugal.

Graduate Hospital Assistant, Orthopedic Clinic, Hospital de Santo Antonio, Porto, Portugal.

出版信息

Rev Bras Ortop. 2015 Dec 8;44(5):432-6. doi: 10.1016/S2255-4971(15)30275-5. eCollection 2009 Jan.

Abstract

OBJECTIVES

Talar neck and body fractures are unusual fractures. The purpose of this study is to determine the prevalence of long term results.

MATERIAL AND METHODS

A retrospective analysis was carried out including 11 patients that underwent surgical treatment for body or neck talus fractures between January 1997 and December 2005. Final follow-up examination included a clinical evaluation (AOFAS score) and standard radiographs.

RESULTS

The mean follow-up time was 58.5 months. The prevalence of associated fractures was 60% (6/10). Overall AOFAS score averaged 72 [19-100]. Avascular necrosis and post-traumatic arthritis were present in half of the patients. Quality of surgical reduction, body fractures and absence of degenerative changes were correlated with better functional results. Neck fractures, osteonecrosis and posttraumatic arthritis led to inferior results.

CONCLUSION

There is a great potential for long term functional impairment due to posttraumatic arthritis and chronic pain in this kind of fracture. Anatomic surgical reduction is the best chance to avoid them but it is not infallible. The avascular necrosis rate correlates with initial fracture displacement, but its occurrence in each specific case is unpredictable.

摘要

目的

距骨颈和体部骨折是不常见的骨折。本研究的目的是确定长期结果的发生率。

材料与方法

进行回顾性分析,纳入1997年1月至2005年12月间接受距骨体或颈骨折手术治疗的11例患者。最终随访检查包括临床评估(美国足踝外科协会评分)和标准X线片。

结果

平均随访时间为58.5个月。合并骨折的发生率为60%(6/10)。美国足踝外科协会评分总体平均为72分[19 - 100分]。一半的患者出现了缺血性坏死和创伤后关节炎。手术复位质量、体部骨折以及无退行性改变与更好的功能结果相关。颈部骨折、骨坏死和创伤后关节炎导致结果较差。

结论

由于创伤后关节炎和此类骨折的慢性疼痛,存在长期功能障碍的巨大可能性。解剖学手术复位是避免这些情况的最佳机会,但并非万无一失。缺血性坏死率与初始骨折移位相关,但其在每个具体病例中的发生是不可预测的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fbd/4783685/53c668d9c2d9/gr1.jpg

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