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采用镁可吸收无头加压螺钉固定内踝骨折:11 例患者的短期临床和影像学结果。

Fixation of medial malleolar fractures with magnesium bioabsorbable headless compression screws: short-term clinical and radiological outcomes in eleven patients.

机构信息

Department of Orthopedics and Traumatology, Antalya Training and Research Hospital, University of Health Sciences, Antalya Egitim ve Arastirma Hastanesi, Soğuksu mah. Kazım Karabekir cd., Muratpaşa, 07100, Antalya, Turkey.

出版信息

Arch Orthop Trauma Surg. 2018 Aug;138(8):1069-1075. doi: 10.1007/s00402-018-2941-x. Epub 2018 Apr 25.

Abstract

OBJECTIVE

The purpose of this retrospective study was to evaluate the outcome of medial malleolar fractures treated with magnesium (MgYREZr) bioabsorbable compression screw fixation.

MATERIALS AND METHODS

Eleven patients with a medial malleolar fracture (either isolated or accompanied by bimalleolar or trimalleolar ankle fractures) who were treated with magnesium bioabsorbable compression screws between 2015 and 2016 in our hospital were retrospectively evaluated. Patients were monitored with a mean follow-up of 17.3 ± 4.1 months (range 12-24 months). The mechanism of injury was ground level falls in all patients. All fractures were classified as closed fractures. American Orthopedic Foot and Ankle Society's (AOFAS) scale and the visual analog scale (VAS) were used to evaluate the clinical results during the final follow-up. Bone union and a possible loss of reduction were assessed with serial radiographs. Potential complications including revision surgery and infection were recorded and reported.

RESULTS

There were 11 patients (4 female, 7 male) with a mean age of 41 ± 21.9 years (range 20-78 years). Six patients had Herscovici type C and five patients had type B fractures. At the final follow-up the mean AOFAS score was 94.9 ± 5.7 points (range 85-100 points) and the mean VAS score was 0.4 ± 1.2 points (range 0-4 points). Radiographic solid union was achieved in all cases. No complications were seen during the follow-up. No patients required implant removal or revision surgery.

CONCLUSIONS

This is the first study that investigates the use of bioabsorbable magnesium compression screws in medial malleolar fractures. The results of this study revealed that fixation of medial malleolar fractures with bioabsorbable magnesium compression screws provides adequate fixation with good functional results.

LEVEL OF EVIDENCE

Level IV, therapeutic, retrospective case series.

摘要

目的

本回顾性研究旨在评估采用镁(MgYREZr)可吸收生物加压螺钉固定治疗内踝骨折的疗效。

材料和方法

对我院 2015 年至 2016 年间采用镁可吸收生物加压螺钉治疗的 11 例内踝骨折(单纯内踝骨折或合并双踝或三踝骨折)患者进行回顾性评估。患者平均随访 17.3±4.1 个月(12-24 个月)。所有患者的损伤机制均为平地跌倒。所有骨折均为闭合性骨折。采用美国矫形足踝协会(AOFAS)评分和视觉模拟评分(VAS)评估末次随访时的临床结果。通过连续影像学评估评估骨愈合和可能的复位丢失情况。记录并报告潜在并发症,包括翻修手术和感染。

结果

共 11 例患者(4 例女性,7 例男性),平均年龄 41±21.9 岁(20-78 岁)。6 例为 Herscovici 分型 C 型骨折,5 例为 B 型骨折。末次随访时,平均 AOFAS 评分为 94.9±5.7 分(85-100 分),平均 VAS 评分为 0.4±1.2 分(0-4 分)。所有病例均获得影像学愈合。随访期间无并发症。无患者需要取出或翻修手术。

结论

这是第一项研究镁可吸收生物加压螺钉在治疗内踝骨折中的应用。本研究结果表明,采用生物可吸收镁加压螺钉固定内踝骨折可提供充分固定,功能结果良好。

证据等级

IV 级,治疗性回顾性病例系列研究。

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