| Objective:1. Summary of pathogenic mechanism, clinical situation, misdiagnosis and its causes of maisonneuve fracture2. Summary of treatment method of maisonneuve fracture3. Evaluation of surgical treatment on maisonneuve fracture4. Analysis postoperative complications, summing up the causes and treatment experienceMaterials and Methods:Retrospective analysis of 20 patients with maisonneuve fracture admitted by Jilin hospital of integrated traditional and western medicine between January,2009 and December,2010. Medical records included sex, age, injury mechanism, x-ray film, fracture treatment and surgical procedures, injury to surgery time, hospital stay time, and complications.19 patients with maisonneuve fracture were followed up,l patient was lost to follow up. And following up to re-examination by return to hospital, visiting home or other ways. All cases were followed up for 3 to 22 months (average 10 months). Scored according to American Association of Foot and Ankle Surgery grading standards. Statistical analysis of some projects were performedResults:There is one Elderly patient use Conservative treatment,the last score achieved 80.According to AOFAS scoring system,excellent results were achieve in 15 patients,good in 2 patients,fair in 1 patient,and poor inl patent.The totle excellent-good rate is 89.5%,operation excellent-good rate is 94.4%. According to the Lauge-Hansen classification,19 cases were grouped as grade III of pronation-external ankle injuries,while 8 cases were grouped as grade IV of pronation-external ankle injuries. According to AOFAS scoring system,excellent results were achieve in 9 patients,good in 1 patient,poor inl patent in the group of grade III, excellent results were achieve in 6 patients,good in 1 patient,fair inl patent in the group of grade IV, Two groups of patients at follow-up results not exist significant differences There are 18 patients treated by surgery,7 patients underwent emergency surgery, the other 11 patients delayed surgery for various reasons. The average hospital stay of Emergency surgery patients is 16.6±2.1d, and the average hospital stay of delayed surgery is 18.5±2.0d, Emergency surgery can obviously reduce the time stay in hospital,and there is no statistical differences of the follow-up result between the two groups.All the patients treated by surgery fixed Syndesmosis diastasis, There are 8 patients through layer 4 cortical screws,10 patients through three layers of cortical screws. All patients who underwent the eight more weeks of X-ray review show did not exist anteroinferior tibiofibular phil separation of radiological findings.10 patients with medial malleolus fractures underwent internal fixation, including six patients fixed by bioabsorbable screw.8 patients with posterior lip ankle fractures underwent internal fixation, including 5 patients fixed by bioabsorbable screw.All the fractures of medial malleolus and posterior lip are well healed according to the X-ray after 8 weeks of operations.Conclusion:1 Maisonneuve fractures are unstable fractures, Regaining fibula length, fixing Syndesmosis diastasis and medial malleolus fractures and rebuildding the stability of ankle mortise by operation after evaluate patients if there is no surgical contraindication can get satisfactory Curative effect.2 Maisonneuve fractures can exist posterior lip ankle fractures, this fractures are treated with open reduction and internal fixation and the X-ray show the fractures of posterior lip are anatomical reduction, There are no statistical difference at follow-up results between the group exist posterior lip fractures and the group not exist posterior lip fractures.3 surgery should as far as possible after an injury 6-8 hours. Early surgery can obviously reduce reduce the time stay in hospital. There are no There are no difference of the Fracture healing between the group of emergency operation and the group of selective operation.4 The screw fix syndesmosis diastasis can fix either 3 layers of cortical and 4 layers of cortical.this two ways can also achieve the stability of Syndesmosis diastasis. 5 For medial malleolus fractures and posterior lip ankle fractures, obey Indications,the bioabsorbable screw can get a excellent results. |
PDF Full Text Request