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手术复位后踝关节骨折的胫腓下关节融合:患者样本的流行病学、临床及形态学评估

Distal tibiofibular synostosis after surgically resolved ankle fractures: An epidemiological, clinical and morphological evaluation of a patient sample.

作者信息

Marvan Jiri, Dzupa Valer, Krbec Martin, Skala-Rosenbaum Jiri, Bartoska Radek, Kachlik David, Baca Vaclav

机构信息

Department of Orthopaedics and Traumatology, Third Faculty of Medicine, Charles University and FNKV, Prague, Czech Republic.

Department of Orthopaedics and Traumatology, Third Faculty of Medicine, Charles University and FNKV, Prague, Czech Republic; Center for Integrated Study of Pelvis, Third Faculty of Medicine, Charles University, Prague, Czech Republic.

出版信息

Injury. 2016 Nov;47(11):2570-2574. doi: 10.1016/j.injury.2016.09.007. Epub 2016 Sep 7.

DOI:10.1016/j.injury.2016.09.007
PMID:27645618
Abstract

INTRODUCTION

Ankle fractures comprise a highly morphologically and etiologically diverse group of injuries, which includes various degrees of impairment of bone and ligamentous structures. The complete synostosis and incomplete bony bridging of tibiofibular syndesmosis are among the local late complications after surgically treated ankle fractures.

PATIENTS AND METHOD

269 patients were evaluated, including 203 patients with Weber type-B fractures, and 66 patients with Weber type-C fractures. All patients underwent ankle radiography at standard intervals (post-operatively, 6 and 12 weeks, 6 and 12 months). The final assessment one year after osteosynthesis was performed. The study analyzed age, sex, fracture morphology, the location and morphology of ossification, functional outcomes and subjective evaluations of patient status.

RESULTS

As risk factors there were found male sex, tibiotalar dislocation, syndesmotic screw fixation and Weber type-C fractures. The severity of subjective difficulties and objective status were not dependent on the size of distal tibiofibular synostosis.

DISCUSSION AND CONCLUSION

Despite relatively extensive imaging findings of complete synostosis or incomplete bony bridging, they only limited functional outcomes to a minimal extent.

摘要

引言

踝关节骨折是一组形态学和病因学高度多样的损伤,包括不同程度的骨骼和韧带结构损伤。胫腓下联合完全性骨桥形成和不完全性骨桥接是手术治疗踝关节骨折后的局部晚期并发症。

患者与方法

对269例患者进行了评估,其中包括203例Weber B型骨折患者和66例Weber C型骨折患者。所有患者均在标准间隔时间(术后、6周和12周、6个月和12个月)进行踝关节X线检查。在骨合成术后一年进行最终评估。该研究分析了年龄、性别、骨折形态、骨化的位置和形态、功能结果以及患者状况的主观评价。

结果

发现危险因素包括男性、胫距关节脱位、下联合螺钉固定和Weber C型骨折。主观困难程度和客观状况并不取决于胫腓下联合远端骨桥的大小。

讨论与结论

尽管完全性骨桥形成或不完全性骨桥接的影像学表现相对广泛,但它们仅在最小程度上限制了功能结果。

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引用本文的文献

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A novel approach for simultaneous tibiofibular synostosis takedown and peroneus longus ligamentoplasty for posttraumatic tibiofibular synostosis: a case report and review of the literature.一种新方法同期行胫腓骨融合松解和腓骨长肌腱韧带成形术治疗创伤性胫腓骨融合:病例报告及文献复习。
J Med Case Rep. 2020 Jul 5;14(1):104. doi: 10.1186/s13256-020-02397-7.
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Management of acute injuries of the tibiofibular syndesmosis.胫腓下联合急性损伤的处理
Eur J Orthop Surg Traumatol. 2017 May;27(4):449-459. doi: 10.1007/s00590-017-1956-2. Epub 2017 Apr 8.