RESUMO
Objective To investigate the treatment effects of different fixation for fracture and dislocation of ankle joint and to sum up the experience for clinical treatment.Methods One hundred and fifty patients with fracture and dislocation of ankle joint using 5 different internal fixation surgeries were involved with this research:simple cross Kirschner wire fixation,intramedullary fixation ordinary screws,cancellous lag screw fixation,4 holes common plate fixation,tension band fixation.Patients were followed up and evaluated by the American Orthopedic Foot and Ankle Society Score for scoring,and investigated the postoperative recovery and the occurrence of postoperative infections and complications in patients.Results After followed up from 12 to 24 months with an average follow-up time of 19 months,of 150 patients,there were 29 cases with excellent result,65 cases with good result,44 cases with general and 12 cases with poor result,the excellent and good rate was 62.6％ (94/150).One case with nonunion,6 cases with malunion,7 cases with traumatic arthritis,10 cases with wound pain,the incidence of postoperative complications was 16.0％ (24/150).There were 10 cases with shallow infection,5 cases with deep infection,and 11 cases with severe skin irritation; The incidence of postoperative infection was 17.3％ (26/150).Conclusion Surgical treatment is the main treatment of fracture and dislocation of ankle joint,5 different methods of internal fixation of ankle fractures had good therapeutic effect.
RESUMO
[Objective]To study the clinical results of treatment of local osteochondral fracture lesions on the talus dome associated with ankle fracture using autologous osteochondral transplantation.[Method]There were 18 patients with osteochondral fracture defects of the talus dome associated with ankle fracture, male 10, female 8, with the average age 33.5 years (18~49 years). Transplantation procedure was osteochondral cylinders from non-weight bearing surface of the ipsilateral knee and implant the donor graft into the recipient holes of talus cartilaginous defects with press-fit technique. The outcomes were assessed on the basis of ankle functional rating score, radiographic findings and MRI findings.[Result]The patients were followed up for 17 to 40 months (mean, 28 months). The ankle functional rating score was measured by the Baird and Jackson functional rating score system. The averaged scores was 96.3?3.5,excellent in 14 cases, good in 3 cases and fair in 1 case. The rate of being excellent and good was 94.4%.The rate of posttraumatic arthritis was 5.6% (1/18) and osteochondritis dissecans was 5.6% (1/18).[Conclusion]Autogenous osteochondral transplantation using ipsilateral knee osteochondral grafts is an effective surgical procedure on treating acute local osteochondral fracture lesions of the talus associated with ankle fracture.