采用改良后内踝入路治疗后踝骨骨折的还原质量

Foot & Ankle Orthopaedics Pub Date : 2024-10-30 eCollection Date: 2024-10-01 DOI:10.1177/24730114241290201
Felipe Pino, Leonardo Lagos, Christian Urbina, Fernando Vargas, Mauricio Parra, Francisco Bravo, Christian Bastias
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引用次数: 0

摘要

背景:踝关节后臼齿骨折的解剖复位是踝关节骨折患者获得良好功能预后的关键目标。虽然有很多方法可以治疗这种类型的骨折,但还没有研究显示使用改良后内踝入路进行术后 CT 扫描后踝臼骨骨折的复位质量:方法:对两家医疗中心的 66 例根据 Bartonicek 分类的 2、3 和 4 型后踝骨臼骨折患者进行了回顾性病例系列研究,采用改良后内踝入路进行治疗。术后 CT 扫描用于评估巩膜缩窄、关节阶差和后踝骨缩窄的残余间隙:结果:4例患者的后踝骨骨折复位为2毫米。61例患者的踝关节复位质量符合解剖学要求。有四名患者的腓骨在轴向出现轻度前移,没有进行再次手术。1例合并韧带缩窄不良:结论:在这项研究中,我们发现92%的后臼齿骨折患者(66例中的61例)在证据级别为IV级的情况下进行了复位:证据级别:IV级,病例系列。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reduction Quality in Posterior Malleolar Fractures Using a Modified Posteromedial Ankle Approach.

Background: Anatomical reduction of posterior malleolar fracture is a key goal in achieving good functional outcomes in patients with ankle fractures. Although there are many approaches for managing this type of fracture, no studies have shown reduction quality of posterior malleolar fracture in postoperative CT scan using the modified posteromedial ankle approach.

Methods: A retrospective case series of 66 patients of 2 health centers with type 2, 3, and 4 posterior malleolar fractures according to Bartonicek classification treated using the modified posteromedial ankle approach was performed. The postoperative CT scan was used to assess syndesmotic reduction and articular step-off and residual gap in posterior malleolus reduction.

Results: Reduction of posterior malleolus fracture was determined to be <2 mm in 62 patients and >2 mm in 4 cases. Syndesmotic reduction quality was considered to be anatomical in 61 patients. Four patients showed mild anterior fibular translation in the axial plane and were not reoperated. One syndesmotic malreduction was considered poor.

Conclusion: In this study, we found that 92% (61 of 66) of patients with posterior malleolar fracture were reduced with <2 mm step-off using this modified posteromedial ankle approach and fracture fixation strategy.

Level of evidence: Level IV, case series.

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来源期刊
Foot & Ankle Orthopaedics
Foot & Ankle Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
1.20
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