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題名 | Fracture of Talar Neck-- A Clinical Experience of Treatment=距骨頸骨折 |
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作者 | 葉敏南; |
期刊 | 中華民國外科醫學會雜誌 |
出版日期 | 19920500、19920600 |
卷期 | 25:3 民81.05-06 |
頁次 | 頁1147-1152 |
分類號 | 416.26 |
語文 | eng |
關鍵詞 | 距骨頸骨折; |
中文摘要 | 長庚紀念醫院,自1979至1988年,21例完整追踪治療的距骨頸骨折患者,患者平均年齡26歲,平均追踪3年10個月依郝金斯分類法,兩例屬於第一類型骨折,五例屬於第二類型骨折,十四例屬於第三類型骨折。第二類骨折百分之二十造成距骨體缺血性壞死。第三類型骨折有百分之四十三造成缺血性壞死。第三類骨折又延遲手術者,百分之百造成缺血性壞死。距骨體缺血性壞死的患者,須使用"保護負重性的支架"。在第三類型骨折,有六位患者的距骨體缺血性壞死,但其中三位患者的距骨體血流再生,最後仍得到滿意的結果。因此,儘早正確的復位並固定,可以降低缺血性壞死的機率,尤其在第三類型的距骨頸骨折,而距骨體缺血性壞死的患者,建議給予保護負重性的支架防止負重的支持,直到血流再生才可停止使用支架。 |
英文摘要 | From 1979 to 1988, 21 cases of talar neck fractures treated at CGMH were reviewed. The average age of the patients was 26 years old and the average follow-up period was 3 years 10 months. By Hawkins' classification there were 2 cases of type I, 5 cases of type II, and 14 cases of type III. There were 20% incidence of avascular necrosis of talar body in the type II fractures and 43% in the type III fractures. But in type III fractures with delayed operation there was a 100% incidence of avascular necrosis of talar body. Patellar-weight-bearing brace was used in those patients with sequela of avascular necrosis. Revascularization was noted in three out of six patients with type III fractures and that had excellent or good results. Early anatomical reduction and rigid fixation reduce the incidence of avascular necrosis of talar neck displaced fracture especially in type III fracture. Protected-weight-bearing brace is suggested in those patients with avascular necrosis of talar body until the revascularization is complete. |
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