Li Jia, Sun Jin-Ke, Wang Chen-Lin
Wendeng Osteopath Hospital, Wendeng 264400, Shandong, China;
Wendeng Osteopath Hospital, Wendeng 264400, Shandong, China.
Zhongguo Gu Shang. 2017 Jun 25;30(6):499-502. doi: 10.3969/j.issn.1003-0034.2017.06.003.
To investigate surgical skills and clinical effects of manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade IV supination-external rotation ankle fractures.
From May 2013 to October 2016, 35 patients with grade IV supination-external rotation ankle fractures were treated with percutaneous Kirschner wire internal fixation, involving 22 males and 13 females with an average age of 38.2 years ranged from 18 to 65 years old. The time from injury to operation ranged from 2 h to 10 d with an average of 5 d. Reduction quality was assessed by Burwell-Charnley radiological criteria. Baird-Jackson ankle scoring system was used to assess clinical effects.
Thirty-three patients were followed up from 10 to 28 months with an average of 14 months. Fracture healing time ranged from 10 to 18 weeks with an average of 12 weeks. According to Burwell-Charnley radiological criteria, 30 cases were obtained anatomic reduction, 3 cases moderate. According to Baird-Jackson ankle scoring system, total score was 93.8±5.4, 17 cases got excellent result, 12 good, 2 fair and 2 poor.
Manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade IV supination-external rotation ankle fractures has advantages of reliable efficacy, less complications. But higher require techniques were required for closed reduction. It is not suitable for severe crushed fracture and compressive articular surface fracture.
探讨手法复位联合经皮克氏针内固定治疗Ⅳ度旋后-外旋型踝关节骨折的手术技巧及临床疗效。
选取2013年5月至2016年10月收治的35例Ⅳ度旋后-外旋型踝关节骨折患者行经皮克氏针内固定治疗，其中男22例，女13例；年龄18～65岁，平均38.2岁。受伤至手术时间2 h至10 d，平均5 d。采用Burwell-Charnley放射学标准评估复位质量，采用Baird-Jackson踝关节评分系统评估临床疗效。
33例患者获得随访，随访时间10～28个月，平均14个月。骨折愈合时间10～18周，平均12周。按Burwell-Charnley放射学标准：解剖复位30例，复位良好3例。按Baird-Jackson踝关节评分系统：总分93.8±5.4分，优17例，良12例，可2例，差2例。
手法复位联合经皮克氏针内固定治疗Ⅳ度旋后-外旋型踝关节骨折疗效可靠，并发症少，但闭合复位技术要求较高，不适用于严重粉碎骨折及关节面压缩骨折。
