钢板联合经皮克氏针固定Chopart关节骨折脱位（开放获取）

Plate internal fixation combined with percutaneous Kirschner wire fixation for Chopart fracture and dislocation

摘要:

[目的] 评价钢板内固定联合经皮克氏针固定Chopart 关节骨折脱位的临床疗效。[方法] 回顾性分析2019 年1 月—2022 年12 月在本院收治的Chopart 关节骨折脱位13 例患者的临床资料，均采用开放复位钢板内固定联合经皮克氏针固定的治疗方式。评价临床及影像学结果。[结果] 所有患者均顺利完成手术，无重要神经、血管损伤等并发症。随访时间平均（20.0±5.4） 个月。末次随访AOFAS 中足评分平均（83.2±6.7） 分，Karlsson-Peterson 评分平均（78.2±7.1） 分。与术前相比，末次随访VAS 评分显著减少[(8.0±0.7), ( 2.5±1.4), P＜0.001]。影像方面，与术前相比，末次随访时患足负重侧位X 线片Meary 角[(15.2±3.2)°, (3.2±2.4)°, P＜0.001] 和侧位台阶征位移距离（step-off sign, SOS） [(9.0±2.1) mm, (1.0±0.8) mm, P＜0.001] 均显著减小。[结论] 钢板内固定联合经皮克氏针固定Chopart 关节骨折脱位手术安全，临床结果满意。

Abstract:

[Objective] To evaluate the clinical efficacy of plate internal fixation combined with percutaneous Kirschner wire fixationfor Chopart fracture and dislocation. [Methods] A retrospective study was conducted on 13 patients who had Chopart fracture and disloca-tion treated by open reduction and plate internal fixation combined with percutaneous Kirschner wire fixation in our hospital from January2019 to December 2022. The clinical and imaging documents were evaluated. [Results] All the 13 patients had operation performed suc-cessfully without important nerve, vascular injury and other complications, and followed up for (20.0±5.4) months in an average. The AO-FAS score was of (83.2±6.7), while the Karlson-Peterson score was of (78.2±7.1) on average. Compared with that preoperatively, the VASscore significantly reduced at the latest follow up [(8.0±0.7), (2.5±1.4), P＜0.001]. As for Imaging, the Meary Angle [(15.2±3.2)°, (3.2±2.4)°,P＜0.001] and step-off sign (SOS) [(9.0±2.1) mm, (1.0±0.8) mm, P＜0.001] on the lateral X-rays with weight bearing significantly reduced atthe last follow-up compared with those before operation. [Conclusion] Plate internal fixation combined with percutaneous Kirschner wirefixation is safe and satisfactory regarding clinical consequence for Chopart fracture and dislocation.