A Retrospective Analysis on Treatment to Ankle Trauma in the Wenchuan Earthquake_West China Medical Journal

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Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan 610041, China;

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Keywords：

踝關節; 地震; 手術治療

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目的:總結2008年5月12日四川汶川地震中,華西醫院救治的踝關節損傷病員的臨床特點和治療經驗。方法:回顧性分析2008年5月12日至2008年6月9日四川大學華西醫院救治的103例踝關節創傷患者的臨床資料。其中資料完整的97例,男59例,女38例,年齡14-76歲,平均34.9歲。根據受傷時的情況(軟組織損傷和踝關節骨折)將軟組織損傷和骨折類型及治療的措施與治療結果進行分析。結果:在我院住院期間,共計46例骨折患者行切開復位內固定,16例行外固定架固定,擴創17例,植皮25人次;根據術后 X 片和關節功能恢復情況評定療效, 局部功能評定按 Leeds 描述的標準, 治療結果分為優、良、差 3級,其中優51例, 良32 例, 差14例,優良率86.6%。至2008年6月9日僅有7例傷口創面未閉合,3例外固定治療的粉碎性骨折尚需進一步手術治療,1例因為感染和肌肉壞死行截肢術;其他傷員骨折復位固定滿意;無一例患者因為踝關節損傷而死亡; 無一例內固定并發癥發生;無一例院內感染發生。結論:我院對地震踝關節損傷的傷員的治療并發癥少,療效良好。

Citation： WU Hui,WANG Guanglin,PEI Fuxin,et al. A Retrospective Analysis on Treatment to Ankle Trauma in the Wenchuan Earthquake. West China Medical Journal, 2009, 24(7): 1669-1672. doi: Copy

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13.	BENCA J, KALAVSKY E, MIKLOSKO J, et al. Infectious diseases in disaster areas/ catastrophes[J]. Neuro EndocrinolLett, 2007, 28,Suppl2:40-43.
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17.	BAR DAYAN Y, LEIBA A, BEARD P, et al. A multidisciplinary field hosp ital as a substitute for medical hosp ital care in the aftermath of an earthquake:the experience of the Israeli Defense Forces Field Hosp ital in Duzce, Turkey, 1999 [J].Prehosp DisasterMed, 2005, 20 (2):103 -106.

1. PAPINEAU I J, AL FAGEME A. Chronic ostomyelitis of long bone resction nad bone grafting with delayed skin closure. J Bone Joint Surg(Br),1976, 58:138.
2. SULTAN S, SHAH A A. Management of open tibial fractures at Ayub Teaching Hospital, Abbottabad. J Ayub Med CollAbbottabad,2001, 13:22-23.
3. SIEGEL I’TORNE~A P 3RD. Extraperiosteal plating of pronation—abduction ankle fractures．J Bone Joint Surg(Am),2007,89(2):276-281．.
4. GRENSHAW A H. Campell’s operative orthopaedics[J ].Louis, 1992, 785 (2):895.
5. KATIOZ H, BOMBACI H, GO RGEC M. Treatment of trimalleolar fractures. Is osteosynthesis needed in posterio rmalleolar fractures measuring less than 25% of the joint surface? [J]. Acta Orthop Traumatol Turc, 2003, 37(4):299-303.
6. LERNER A, STEINH. Hybrid thin wire external fixation:an effective,minimally invasive,modular surgical tool forth estabilization of periarticular fractures[J].Orthopedics,2004,27(1):59-62.
7. EGOL K A, WEISZ R, HIEBERT R, et al. Does fibular plating improve alignment after intramedullary nailing of distal metaphyseal tibia fractures? J Orthop Trauma,2006,20(2):94-103.
8. TORNETTA P 3RD. Competence of the deltoid 1igment in bimalleolar ankle fractures after medial malleoar fixatoin． Bone Joint Surg(Am),2000,82(6):843-848.
9. IM G I,TAE S K. Distal metaphyseal fractures of tibia:a prospective randomized trial of closed reduction and intramedullary nail versus open reduction and plate and screws fixation．J Trauma,2005,59(5):l219-1223.
10. Rose J D, Flanigan K P, Mlodzienski A. Tibiofibular diastasis without ankle fracture:a review an d report of two cases．J Fot Ankle Surg,2002,4l(1):44-51.
11. JOUKAINEN A, PARTIO E K, WARIS P, et al. Bioabsorbable screw fixation for the treatment of ankle fractures．J Orthop Sci,2007,l2(1):28-34.
12. CAUDLE R J, STERN P J. Severe open fractures of t he tibia[J]. J Bone Joint Surg Am,1987,69 (6):801-807.
13. BENCA J, KALAVSKY E, MIKLOSKO J, et al. Infectious diseases in disaster areas/ catastrophes[J]. Neuro EndocrinolLett, 2007, 28,Suppl2:40-43.
14. 王愛民,吳選道．長骨干開放性骨折傷口感染原因分析．骨與關節損傷雜志,1992,3:173.
15. BRATZLER D W, HOUCK P M, RICHARDS C, et al. Use of antimicrobial prophylaxis for major surgery:baseline from the national surgical infection prevention project. Arch Surg,2005,140:174-182.
16. HOINESS P, STROMSOE K. The influence of the timing of surgery on soft tissue complications and hospital stay:a review of 84 closed ankle fractures[J].Ann Chir Gynaecol,2000,89 (1):629.
17. BAR DAYAN Y, LEIBA A, BEARD P, et al. A multidisciplinary field hosp ital as a substitute for medical hosp ital care in the aftermath of an earthquake:the experience of the Israeli Defense Forces Field Hosp ital in Duzce, Turkey, 1999 [J].Prehosp DisasterMed, 2005, 20 (2):103 -106.

West China Medical Journal

A Retrospective Analysis on Treatment to Ankle Trauma in the Wenchuan Earthquake

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