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find Author "马海东" 4 results
  • 微型网状钛板“捆扎式”固定治疗跟骨前结节骨折

    目的总结采用微型网状钛板“捆扎式”固定治疗跟骨前结节骨折的疗效。 方法2010年8月-2013年8月,采用切开复位微型网状钛板“捆扎式”固定治疗跟骨前结节骨折13例(13足)。男8例,女5例;年龄20~53岁,平均37.5岁。致伤原因:扭伤9例,高处坠落伤4例。伤后至手术时间4~8 d,平均5.5 d。 结果患者切口均Ⅰ期愈合。13例患者均获随访,随访时间6~18个月,平均10.5个月。X线片复查示,骨折均愈合,愈合时间3~6个月,平均4.5个月;均未发生骨不连,随访期间无创伤性骨关节炎发生。1例患者行走时跟骰关节偶感疼痛。末次随访时,根据美国矫形足踝协会(AOFAS)足部评分标准,获优11例,良1例,可1例,优良率为92.3%。 结论采用微型网状钛板“捆扎式”固定跟骨前结节骨折,避免了跨跟骰关节固定,有利于关节功能的恢复。

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  • 单纯第一跖骨基底部闭合性粉碎骨折脱位的治疗

    目的总结手术治疗单纯第1跖骨基底部闭合性粉碎骨折脱位的方法及疗效。 方法2009年2月-2013年10月,采用切开复位微型接骨板跨关节桥式支撑内固定治疗9例(9足)单纯第1跖骨基底部闭合性粉碎骨折脱位。男7例,女2例;年龄22~65岁,平均38.5岁。致伤原因:高处坠落伤6例,扭伤3例。根据Myerson跗跖关节骨折脱位分型,均为B1型。其中3例骨折端骨质压缩。受伤至手术时间2~4 d,平均2.7 d。 结果术后切口均Ⅰ期愈合。患者均获随访,随访时间1年1个月~3年,平均1年8个月。骨折均愈合,愈合时间10~12周,平均10.8周。术后5例固定接骨板靠近关节侧的螺钉断裂,未作特殊处理;9例均于术后6个月~2年取出内固定物。末次随访时,按照美国矫形足踝协会(AOFAS)标准评分为80~95分,平均88.4分。 结论微型接骨板跨关节桥式支撑内固定具有手术操作简便、固定牢固、减少关节面损伤、断钉易取出等优点,是治疗第1跖骨基底部闭合性粉碎骨折脱位理想方法之一。

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  • CLASSIFICATION OF ADULT CUBOID FRACTURE AND EFFECTIVENESS ANALYSIS

    ObjectiveTo study the classification criteria of adult cuboid fracture and its guidance feasibility and effect of treatment. MethodsA retrospective analysis was made on the clinical data of 415 adult patients (416 feet) with cuboid fractures who had complete CT data treated between May 2009 and April 2014. There were 337 males and 78 females, aged 19 to 64 years (mean, 38.8 years). The left foot, right foot, and bilateral feet were involved in 220 cases, 194 cases, and 1 case respectively. The causes of injury were sprain in 106 cases, traffic accident in 65 cases, falling from height in 129 cases, and heavy crushing in 115 cases. The interval of injury and hospitalization was 2 hours to 3 days (mean, 8.5 hours). Based on CT findings, the classification criteria of cuboid fracture was proposed and methods of treatment was statistically analyzed. The external fixation surgery was performed in patients of type I (285 feet), type IIa (18 feet), and type III (5 feet); open reduction and internal fixation were performed in patients of type IIb (41 feet) and type III (67 feet), and bone grafting was used to repair defects in 58 feet (type III). ResultsAll patients were followed up 1 year to 5 years and 11 months (mean, 2 years and 3 months). Primary healing of incision was obtained. In patients with type I fracture, fracture healed in 165 feet at 4-6 weeks (mean, 5.5 weeks), fracture did not heal in the other 120 feet; the American Orthopaedic Foot and Ankle Society (AOFAS) score was 95-100(mean, 96.7) at last follow-up. In patients with type II fracture, fracture healed in all feet at 6-8 weeks (mean, 6.5 weeks); the AOFAS score was 92-100(mean, 95.5) at last follow-up. In patients with type III fracture, malunion was observed at 6-8 weeks in 5 feet undergoing external fixation, and in 9 feet undergoing open reduction and internal fixation with foot lateral column shortening, forefoot abduction deformity, osteoarthritis, lateral foot pain; fracture healed at 8-12 weeks in 58 feet undergoing open reduction and internal fixation, without osteoarthritis, cuboid bone shortening, and pain at cuboid bone; and AOFAS score was 75-97(mean,93.5) at last follow-up. ConclusionThe classification criteria of cuboid fracture proposed based on CT examination is feasible and has guiding significance to the choice of treatment method.

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  • ANALYSIS OF DIAGNOSIS AND TREATMENT OF TALUS LATERAL PROCESS FRACTURE

    Objective To analyse and summarize the diagnosis, treatment, and cl inical effects of talus lateral process fracture. Methods Between February 2001 and March 2009, 21 male patients with an average age of 33.6 years (range, 18-46years) with talus lateral process fractures were treated. Fracture was caused by fall ing from height in 18 cases, by tumbl ing in 2 cases, and by sprain in 1 case. According to Hawkins classification, there were 4 cases of type I, 15 cases of type II, and 2 cases of type III, all being closed fractures. The disease course was from 2 hours to 26 days. In 17 patients whose fracture fragments were more than 1 cm × 1 cm × 1 cm or whose fracture fragments shifting was more than 1 mm, open reduction and internal fixation with AO hollow titanium nails were performed in 14 patients, open reduction and internal fixation with door-shape self-made nail in 1 patient, and open reduction and internal fixation with absorbable screws in 2 patients. In 4 patients whose fracture fragments were less than 0.6 cm × 0.5 cm × 0.5 cm or whose fracture fragments shifting was less than 1 mm, fragments removel was performed in 2 patients, Kirschner pins in 1 patient, and plaster conservative therapy in 1 patient. In patients with l igaments injury, the l igaments was reconstructed during the operation. Results All the incisions achieved primary heal ing. Twenty-one patients were followed up 9.5 months to 8 years. No ankle pain occurred and the range of joint motion was normal after operation. The X-ray films showed that all cases achieved fracture union. And the healing time was from 8 weeks to 14 weeks (10 weeks on average). According toAmerican Orthopeadic Foot amp; Ankle Society (AOFAS) for foot, the results were excellent in 17 cases, good in 3 cases, and moderate in 1 case; the excellent and good rate was 95.24%. Conclusion The size and displacement of fracture fragment should be considered first in the treatment of lateral process fracture of talus; in patients who are compl icated by lateral malleolus l igament injury, the l igament should be reconstructed to avoid the chronic non-stabil ity of lateral ankle.

    Release date:2016-08-31 05:48 Export PDF Favorites Scan
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