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find Keyword "下胫腓联合损伤" 6 results
  • EFFECTIVENESS COMPARISON BETWEEN ABSORBABLE AND METALLIC SCREWS FOR TREATMENT OF TIBIOFIBULAR SYNDESMOTIC DISRUPTIONS

    Objective To investigate the feasibility and effectiveness of absorbable screws for the treatment of tibiofibular syndesmotic disruptions by comparing with metallic screws. Methods Between July 2007 and May 2012, 69 patients with tibiofibular syndesmotic disruptions associated with ankle fractures were treated; absorbable screw fixation was used in 38 cases (group A) and metallic screw fixation was used in 31 cases (group B). There was no significant difference in gender, age, injury causes, the type of fracture, the side of fracture, and disease duration between 2 groups (P gt; 0.05). The fracture healing time, weight bearing time, and complications were recorded and compared between 2 groups. According to Baird-Jackson scoring system, the function of the ankle was assessed after 6 months. Results Infection of incision occurred in 3 cases (7.9%) of group A and 2 cases (6.5%) of group B, and skin necrosis of incision in 1 case (2.6%) of group A and 5 cases (16.1%) of group B, showing no significant difference in the incidences of infection and necrosis of incisions between 2 groups (P gt; 0.05); primary healing of incision was obtained in the other patients. The 69 cases were followed up 12-26 months (mean, 18.6 months). The weight bearing time was (2.97 ± 0.59) months in group A and was (3.16 ± 0.74 ) months in group B, showing no significant difference (t=1.175, P=0.244). X-ray films showed that fractures and tibiofibular syndesmotic disruptions healed in 2 groups; the healing time was (5.71 ± 1.01) months in group A and was (5.81 ± 1.08) months in group B, showing no significant difference (t=0.381, P=0.705). No fixation failure, breakage, or loosening occurred in 2 groups. According to Baird-Jackson scoring system, the results were excellent in 29 cases, good in 5 cases, and fair in 4 cases with an excellent and good rate of 89.5% in group A at 6 months after operation; the results were excellent in 20 cases, good in 7 cases, and fair in 4 cases with an excellent and good rate of 87.1% in group B; no significant difference was found in the excellent and good rate between 2 groups (Z= — 0.991, P=0.321). Conclusion Treatment of tibiofibular syndesmotic disruptions with absorbable screws can get good effectiveness and replace metallic screws because of avoiding additional operation for removing the screw.

    Release date:2016-08-31 10:53 Export PDF Favorites Scan
  • 锁定钢板联合纽扣钢板线缆系统治疗Weber-C型踝部骨折

    目的 总结采用锁定钢板联合纽扣钢板线缆系统治疗Weber-C型踝部骨折的疗效。 方法 2011年2月-9月,对25例Weber-C型踝部骨折采用锁定钢板固定外踝、空心螺钉固定内踝及后踝、纽扣钢板线缆系统重建下胫腓联合治疗。男16例,女9例;年龄22~44岁,平均33.4岁。致伤原因:扭伤14例,交通事故伤9例,高处坠落伤2例。左侧12例,右侧13例。受伤至手术时间2~7 d,平均2.6 d。 结果术后第2天踝部正侧位X线片检查示,下胫腓联合间隙、踝穴均恢复正常。患者切口均Ⅰ期愈合,无相关并发症发生。25例均获随访,随访时间12~28个月,平均25.2个月。骨折均愈合,愈合时间9~13个月,平均12个月;无骨折复位丢失以及下胫腓联合固定失效发生。术后12个月根据美国矫形足踝协会(AOFAS)踝关节功能评分系统评分,获优21例,良4例,优良率为100%。 结论锁定钢板联合纽扣钢板线缆系统治疗Weber-C型踝部骨折,避免了单螺钉固定下胫腓联合的相关并发症,近期疗效满意。

    Release date:2016-08-31 10:53 Export PDF Favorites Scan
  • PROGRESS IN DIAGNOSIS AND TREATMENT OF DISTAL TIBIOFIBULAR SYNDESMOSIS INJURY

    Objective To review the progress in the diagnosis and treatment of distal tibiofibular syndesmosisinjury. Methods Different kinds of documents were widely collected, current developments of the diagnosis and treatmentof distal tibiofibular syndesmosis injury were summarized. Results The disease history (damage mechanism), cl inicalexamination, and imaging examination (X-ray, CT scan, and MRI) can assist the diagnosis of distal tibiofibular syndesmosisinjury. Patients with unstable distal tibiofibular syndesmosis injury needs active surgery treatment, and the princi ple isanatomical reduction and fixation so as to avoid the instabil ity of the ankle joint, long-term chronic pain, and traumaticarthritis. Conclusion The diagnosis of distal tibiofibular syndesmosis injury is still lack of specific quantitative parameters, socl inical study for large sample is needed to explicit the effectiveness.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • CT 扫描诊断下胫腓联合损伤的应用评价

    目的 评估CT 扫描诊断下胫腓联合损伤的应用价值,为临床诊断下胫腓联合损伤提供有效的诊断方法。 方法 2007 年3 月- 2009 年2 月,收治68 例闭合性踝部骨折患者。男45 例,女23 例;年龄18 ~ 63 岁,平均36.7 岁。Lange-Hanson 分型:旋前外旋型23 例,旋前外展型19 例,旋后外旋型12 例,旋后内收型11 例,垂直压缩型3 例。Denis-weber 分型:A 型7 例,B 型28 例,C 型33 例。受伤至手术时间6 ~ 144 h,平均94 h。术前常规摄X 线片及行CT扫描诊断下胫腓联合损伤情况。采取切开复位内固定治疗,术中探查下胫腓联合损伤情况并作为“金标准”,与术前X 线片和CT 扫描结果进行统计学比较分析。 结果 术中手术探查46 例存在下胫腓联合损伤,22 例未见损伤。术前X 线片诊断下胫腓联合损伤真阳性25 例,真阴性16 例,假阳性6 例,假阴性21 例,灵敏度54.34% ± 14.38%,特异度72.72% ±18.60%,准确度60.29% ± 11.62%,阳性预测值80.64% ± 13.89%,阴性预测值43.24% ± 20.34%;术前CT 扫描诊断真阳性43 例,真阴性21 例,假阳性1 例,假阴性3 例,灵敏度93.47%±7.11%,特异度95.45% ± 8.66%,准确度94.11% ± 5.58%,阳性预测值97.72% ± 4.39%,阴性预测值87.50% ± 13.21%;CT 扫描各指标均明显高于X 线片(P lt; 0.05)。Kappa 指数显示CT 扫描与手术探查结果存在一致性,可靠性高;X 线片可靠性低。 结论 单纯根据X 线片诊断下胫腓联合损伤可靠性低,CT 扫描诊断下胫腓联合损伤可靠性高、真实性好,能够提供重要的临床参考价值。

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • BIOMECHANICAL STUDY ON REPAIRING DISTAL TIBIOFIBULAR SYNDESMOSIS INJURIES WITH ARTIFICIAL LIGAMENTS

    ObjectiveTo investigate the biomechanical properties of artificial ligament in the treatment of injuries to distal tibiofibular syndesmosis so as to provide a scientific basis for clinical application. MethodsSixteen fresh ankle specimens were harvested from 8 normal fresh-frozen cadavers. The initial tests were performed on 16 intact specimens (group A) and then the distal tibiofibular syndesmosis injury models were made (group B); the distal tibiofibular syndesmosis was fixed with artificial ligament in 8 specimens (group C) and with cannulated lag screw in the other 8 specimens (group D). The pros and cons of different fixation methods were analyzed by displacement, stress shielding effect, the strength and stiffness of ankle joints, the contact area of tibiotalar articular surface and the contact stress. ResultsUnder the physiological loading or combined with external rotation moment, the displacement of group C was significantly lower than that of groups B and D (P < 0.05), but no significant difference was found between groups A and C (P > 0.05); and there were significant differences among groups A, B, and D (P < 0.05). The rates of stress shielding in the tibia and fibula of group C were significantly lower than those of group D (t=-71.288, P=0.000;t=-97.283, P=0.000). The stress strength in tibia of group C was significantly higher than that of groups A and D (P < 0.05), but no significant difference was found between groups A and D (P > 0.05). Group C had the highest stress strength in fibula, followed by group A, group D had the lowest; differences were significant among 3 groups (P < 0.05). There was no significant difference in shear strength among groups A, C, and D (P > 0.05). The axial stiffness in tibia of group D was significantly lower than that of groups A and C (P < 0.05), but no significant difference was found between groups A and C (P > 0.05). The axial stiffness in fibula of group C was significantly higher than that of groups A and D (P < 0.05), but no significant difference was found between groups A and D (P > 0.05). Group C had the highest shear stiffness in tibia and fibula, followed by group D, group A had the lowest; differences were significant among 3 groups (P < 0.05). In groups A, C, and D, the contact area of tibiotalar articular surface gradually reduced, and the contact stress gradually increased, and differences were significant among 3 groups (P < 0.05). ConclusionFixation of distal tibiofibular syndesmosis injury with artificial ligament can better meet the physiological functions of the distal tibiofibular syndesmosis and has lower stress shielding, better stress distribution. Hopefully, it can reduce the complications of the distal tibiofibular syndesmosis injuries and become a better treatment choice.

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  • Research progress in diagnosis and treatment of distal tibiofibular syndesmosis injury

    ObjectiveTo review the research progress in the diagnosis and treatment of distal tibiofibular syndesmosis injury.MethodsThe recent literature about distal tibiofibular syndesmosis injury was reviewed and analyzed.ResultsDistal tibiofibular syndesmosis injury is commonly seen in ankle joint injury, the anatomical complexities make diagnosis and treatment difficult. Preoperative physical examination, radiologic evaluation, and intraoperative stress-testing are important for the diagnosis. Aggressive treatment is also recommended for these injuries to prevent long-term chronic instability. Internal fixation is the main treatment, including metal screw, degradable screw, elastic fixation, and hybrid techniques. Metal screw fixation is still the current mainstream, but elastic fixation represented by Suture-button is more in line with the physiological characteristics of ankle joint, and the rate of secondary operation is low while the clinical outcome is satisfactory. The application prospect of elastic fixation is worthy of expectation.ConclusionIt’s crucial for patient with ankle fracture to repair the distal tibiofibular syndesmosis injury. How to diagnose the injury more accurately and simply, how to increase the success rate of reduction, and how to reduce the complications of surgery are still worthy for further exploration.

    Release date:2020-11-02 06:24 Export PDF Favorites Scan
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