■本研究旨在报告HawkinsIII分类距骨颈骨折手术治疗后的中期结果。
从2010年3月到2022年4月,在我院就诊的155例距骨骨折患者中,31例HawkinsⅢ类距骨颈骨折患者接受手术治疗。纳入标准包括症状持续时间超过1年的患者,可进行门诊随访并在手术后2个月接受磁共振成像(MRI)随访。排除标准包括术前没有踝关节周围关节炎的患者,共纳入27例患者.交通事故和跌倒占23例的86%,开放性骨折8例,平均随访期为34.10个月(范围,12-80个月)。通过美国骨科足踝协会(AOFAS)评分和足功能指数(FFI)测量临床结果,使用手术前后的简单X线照片和术后2个月的MRI获得放射学结果,以确认骨愈合和并发症。
■在所有情况下都实现了完全的骨愈合,工会的平均持续时间为4.9个月(范围,4-6个月),没有骨不连和内翻畸形。在最后的后续行动中,平均AOFAS评分为80.18分(范围,36-90分),平均FFI评分为31.43分(范围,10-68分),显示相对良好的临床结果。血管坏死15例,创伤性踝关节关节炎6例,胫骨后神经刺激6例,4例伤口问题。
■Hawkins分类III距骨颈骨折大多由高能量损伤引起,由于无血管坏死或创伤性关节炎等并发症的发生率较高,预后相对较差。然而,如果在受伤后的短时间内进行了正确的解剖复位和刚性内固定,可以预期良好的结果。
UNASSIGNED: This study aims to report the midterm outcomes after surgical treatment of Hawkins Classification III Talar neck fractures.
UNASSIGNED: From March 2010 to April 2022, among a total of 155 patients who visited our hospital with talus fractures, 31 patients underwent surgical treatment for Hawkins classification III talar neck fractures. The inclusion criteria comprised patients with a symptom duration of over 1 year who were available for outpatient follow-up and underwent magnetic resonance imaging (MRI) follow-up 2 months after surgery. Exclusion criteria included patients without preoperative ankle periarticular arthritis, and a total of 27 patients were enrolled. Traffic accidents and falls accounted for 86% of 23 cases, open fractures were 8 cases, and the mean follow-up period was 34.10 months (range, 12-80 months). Clinical outcomes were measured by American Orthopaedic Foot and Ankle Society (AOFAS) score and Foot function index (FFI), and radiological results were obtained using simple radiographs before and after surgery and MRI at 2 months postoperatively to confirm bone union and complications.
UNASSIGNED: Complete bone union was achieved in all cases, and the mean duration of union was 4.9 months (range, 4-6 months) and there were no nonunion and varus malunion. At the final follow-up, the mean AOFAS score was 80.18 points (range, 36-90 points) and the mean FFI score was 31.43 points (range, 10-68 points), showing relatively good clinical outcomes. There were 15 cases of avascular necrosis, 6 cases of traumatic arthritis of the ankle joint, 6 cases of irritation of the posterior tibial nerve, and 4 cases of wound problems.
UNASSIGNED: Hawkins classification III talar neck fractures are mostly caused by high-energy injuries and have a relatively poor prognosis due to the high incidence of complications such as avascular necrosis or posttraumatic arthritis. However, if correct anatomical reduction and rigid internal fixation are performed within a short time after the injury, good results can be expected.