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使用胫腓近端螺钉固定腓骨头撕脱骨折:技术指南与临床经验

Fixation of fibular head avulsion fractures with the proximal tibiofibular screw: Technique guide and clinical experience.

作者信息

Paul Ryan A, Hu Shu Yang, Pathak Ananya, Khan Ryan, Whelan Daniel B

机构信息

Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Division of Orthopedic Surgery, Department of Surgery, University Health Network (UHN), Toronto, Ontario, Canada.

出版信息

Trauma Case Rep. 2025 Apr 28;57:101175. doi: 10.1016/j.tcr.2025.101175. eCollection 2025 May.

DOI:10.1016/j.tcr.2025.101175
PMID:40453450
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12124724/
Abstract

BACKGROUND

Fibular head avulsion fractures are often associated with posterolateral corner injuries. Conventional fixation have consisted of transosseous or anchor-based suture techniques.

PURPOSE

This technique paper reports on the use of a cannulated screw for fixation of fibular head avulsion fractures by a single surgeon at a tertiary referral center.

METHODS

Thirty-seven patients underwent open reduction and internal fixation of fibular head avulsion fractures between 2006 and 2022.

RESULTS

At final follow up (mean 3.5 years ± 2.5) all fractures went on to bony union. All patients regained functional range of motion with mean extension of 1 degree (median 0 degrees, range 0 to -5 degrees) and mean flexion of 121 degrees (median 127.5 degrees, range 90 to 135 degrees).

CONCLUSION

Our results suggest that a cannulated screw across multiple cortices provides robust fixation and allows for early motion.

摘要

背景

腓骨头撕脱骨折常与后外侧角损伤相关。传统固定方法包括经骨或锚钉缝合技术。

目的

本技术论文报道了一名外科医生在三级转诊中心使用空心螺钉固定腓骨头撕脱骨折的情况。

方法

2006年至2022年期间,37例患者接受了腓骨头撕脱骨折的切开复位内固定术。

结果

在末次随访时(平均3.5年±2.5年),所有骨折均实现骨性愈合。所有患者均恢复了功能活动范围,平均伸直角度为1度(中位数0度,范围0至-5度),平均屈曲角度为121度(中位数127.5度,范围90至135度)。

结论

我们的结果表明,穿过多个皮质的空心螺钉可提供牢固的固定,并允许早期活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/2db03f725f05/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/4f71e6cc5865/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/431411bb2c18/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/fb03fc06688b/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/418affcd67c3/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/d1cf3f2d3002/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/172e6f9b69cf/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/a9c828fc056f/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/2db03f725f05/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/4f71e6cc5865/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/431411bb2c18/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/fb03fc06688b/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/418affcd67c3/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/d1cf3f2d3002/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/172e6f9b69cf/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/a9c828fc056f/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/12124724/2db03f725f05/gr8.jpg

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本文引用的文献

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Fibular head avulsion fractures accompanying operative treated medial tibial plateau fractures.伴有手术治疗的胫骨内侧平台骨折的腓骨头撕脱骨折。
Skeletal Radiol. 2019 Sep;48(9):1411-1416. doi: 10.1007/s00256-019-03191-3. Epub 2019 Mar 5.
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Complex Fibular Head Avulsion Fracture: Surgical Management of a Case.复杂腓骨头撕脱骨折:1例病例的手术治疗
Surg Technol Int. 2018 Jun 1;32:257-260.
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Double-Row Suture Anchor Repair of Posterolateral Corner Avulsion Fractures.后外侧角撕脱骨折的双排缝线锚钉修复术
Arthrosc Tech. 2017 Jul 10;6(4):e997-e1001. doi: 10.1016/j.eats.2017.03.011. eCollection 2017 Aug.
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Novel Spiked-Washer Repair Is Biomechanically Superior to Suture and Bone Tunnels for Arcuate Fracture Repair.新型带刺垫圈修复术在生物力学上优于缝线和骨隧道用于弓形骨折修复。
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