改良克氏针钢丝张力带联合锁定螺钉固定治疗Herscovici B、C型内踝骨折的近期疗效

徐铭浩; 柯追; 于诗洋; 赵锁柱; 栾洪坤; 孙浩

doi:10.62177/fcdt.v2i5.1714

作者

徐铭浩联勤保障部队第九六七医院创伤外科
柯追同济大学附属第十人民医院全科
于诗洋联勤保障部队第九六七医院创伤外科
赵锁柱联勤保障部队第九六七医院创伤外科
栾洪坤联勤保障部队第九六七医院创伤外科
孙浩联勤保障部队第九六七医院创伤外科

DOI:

https://doi.org/10.62177/fcdt.v2i5.1714

关键词:

内踝骨折, Herscovici分型, 克氏针, 张力带, 锁定螺钉

摘要

目的：评价改良克氏针钢丝张力带联合锁定螺钉固定治疗Herscovici B、C型内踝骨折的近期临床与影像学结果。 方法：回顾性纳入2023年10月至2025年12月在联勤保障部队第九六七医院接受该术式治疗且完成随访的30例患者。记录术前及术后1周、1、3、6、9个月Olerud-Molander踝关节评分（OMAS）和美国骨科足踝协会（AOFAS）踝-后足评分，并观察骨折愈合、复位维持、内固定相关并发症及内固定取出时间。 结果：平均随访时间为（9.01±0.58）个月。OMAS由术前（15.40±1.24）分升至术后9个月（90.83±0.49）分，AOFAS评分由（14.27±2.42）分升至（91.47±2.85）分；末次随访两种评分的优良率均为100%（30/30）。所有患者末次随访均达到影像学骨性愈合，未见骨不连、畸形愈合、复位丢失、内固定失效或克氏针移位；1例（3.3%）出现轻度内固定物激惹，经保守处理后缓解。内固定取出时间为（7.06±0.78）个月。 结论：在严格选择的Herscovici B、C型内踝骨折患者中，该改良固定方式可获得稳定复位和较好的近期功能结果。受单中心、小样本、无对照及随访期较短等限制，尚需前瞻性对照研究验证其相对优势。

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