Armstrong Lesley, Jackson John, Riddick Andrew
Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol BS10 5NB, United Kingdom.
Foot Ankle Surg. 2018 Aug;24(4):347-352. doi: 10.1016/j.fas.2017.03.015. Epub 2017 Apr 13.
Gustilo-Anderson grade 3B open ankle fracture-dislocations requiring stable fixation and soft tissue coverage are increasingly common in frail populations.
We identified all patients with open ankle fracture-dislocations treated with a tibiotalocalcaneal nail and soft tissue coverage over a five-year period. We retrospectively recorded pre-morbid status, fracture and soft tissue injury pattern, surgical details, post-operative mobility, length of hospital stay, complication and re-operation rate and survival.
21 ankles (20 patients) are included, all grade 3B open fractures. All patients were permitted to mobilise by one to six weeks post-surgery. One patient required further soft tissue surgery. Six patients had superficial wound colonization/infection, none developed deep infections. None of the nails have required removal. We observed a 15% three-month mortality rate.
Tibiotalocalcaneal nail fixation and soft tissue coverage of unstable open ankle fractures in frail patients facilitates early return to ambulation with a low complication and re-operation rate.
对于虚弱人群而言，需要稳定固定和软组织覆盖的 Gustilo-Anderson 3B 级开放性踝关节骨折脱位越来越常见。
我们确定了在五年期间接受胫距跟骨钉固定和软组织覆盖治疗的所有开放性踝关节骨折脱位患者。我们回顾性记录了术前状态、骨折和软组织损伤模式、手术细节、术后活动能力、住院时间、并发症及再次手术率和生存率。
纳入 21 个踝关节（20 例患者），均为 3B 级开放性骨折。所有患者在术后 1至6周被允许活动。1例患者需要进一步的软组织手术。6例患者出现表浅伤口定植/感染，均未发生深部感染。所有钉子均无需取出。我们观察到三个月死亡率为 15%。
对于虚弱患者的不稳定开放性踝关节骨折，采用胫距跟骨钉固定和软组织覆盖可促进早期恢复行走，并发症和再次手术率较低。
