Objective To investigate the clinical effect of digital technology assisted minimally invasive percutaneous screw fixation in the treatment of talar posterior process fractures. Methods A total of 19 patients with talar fracture treated from June 2014 to December 2018 were selected, including 13 males and 6 females, aged from 28 to 57 years, with an average of 37.7 years. The causes of injury were 5 cases of car accident injuries, 11 cases of fall injuries from heights, and 3 cases of sprains. There were 11 cases of talar posterior process fracture, 4 cases of subtalar joint dislocation, 2 cases of ankle fracture, and 2 cases of calcaneus fracture. Digital technology was used to perform precise minimally invasive surgery on the above patients. The AOFAS Ankle Hindfoot Scale and Visual Analogue Score (VAS score) were used to evaluate the function of the affected foot before operation and at the last follow-up. Results Nineteen patients were followed up for 9 months to 22 months, with an average of 14.2 months. All patients had no complications such as incision infection, fracture displacement, vascular and nerve injury, and unhealed bone. AOFAS ankle-hindfoot score: preoperative (38.8±12.4) points and postoperative (87.0 ±6.4) points. VAS score: preoperative (4.8±1.2) points and postoperative (1.0±0.7) points. The AOFAS ankle- hindfoot score was excellent in 17 cases of patients and good in 2 cases of patients. Conclusions The application of digital technology assisted minimally invasive percutaneous screw fixation in the treatment of talar posterior process fractures can improve the accuracy of surgery, shorten the operation time, and reduce surgical trauma.
Key words
Digitalization; /
Individualization; /
Minimally invasive; /
Posterior process fracture of talus
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References
[1] 李卫华, 王岩, 王满宜. 距骨体与距骨颈骨折手术疗效分析[J]. 中华创伤骨科杂志, 2006, 8(5): 422-425. DOI: 10.3760/cma.j.issn.1671-7600.2006.05.007.
[2] Bhanot A, Kaushal R, Bhan R, et al. Fracture of the posterior process of talus[J]. Injury, 2004, 35(12): 1341-1344. DOI: 10.1016/j.injury.2003.10.025.
[3] Ahmad R, Ahmed SMY. Fracture of the posterior process of the talus: an unusual injury[J]. Emerg Med J, 2007, 24(12): 867. DOI: 10.1136/bcr.2006.045609.
[4] Berkowitz MJ , Kim DH . Process and tubercle fractures of the hindfoot[J]. J Am Acad Orthop Surg, 2005, 13(8): 492-502. DOI: 10.5435/00124635-200512000-00002.
[5] 王家洪, 周小平, 朱红, 等. 距骨后突骨折的治疗[J]. 中国现代医药杂志, 2013, 15(9): 79-80. DOI: 10.3969/j.issn.1672-9463.2013.09.027.
[6] 庞施义, 李忠华, 王庆荣, 等. 距骨尾的命名及距骨尾骨折[J]. 中华骨科杂志, 1999, 19(10): 600-603. DOI: 10.3760/j.issn:0253-2352.1999. 10.007.
[7] 王庆荣, 庞施义, 朱冬承, 等. 距骨尾部骨折16例报告[J]. 中国骨与关节损伤杂志, 1996, 0(5): 288-289. DOI: CNKI:SUN:GGJS.0.1996-05-020.
[8] 施忠民, 顾文奇, 张长青, 等. 经踝后内侧入路切开复位内固定治疗距骨后突骨折[J]. 中华创伤骨科杂志, 2010, 12(8): 715-718. DOI: 10.3760/cma.j.issn.1671-7600.2010.08.004.
[9] Giebel GD, Meyer C, Koebke J, et al. The arterial supply of the ankle joint and itsimportance for the operative fracture treatment[J]. Surg Radiol Anat, 1997,19(4): 231-235. DOI: 10.1007/BF01627863.
[10] 邵云潮, 张光健, 周建平. 距骨的血液供应及其临床意义[J]. 中华骨科杂志, 1997, 17(7): 457-460. DOI: 10.3760/j.issn:0253-2352. 1997. 07.019.
[11]Cedell CA. Rupture of the posterior talotibial ligament with the avulsion of a bone fragment from the talus[J]. Acta Orthop Scand, 1974, 45(3): 454-461. DOI: 10.3109/17453677408989168.
[12]Kanbe K, Kubota H, Hasegawa A, et al. Fracture of the posterior medial tubercle of the talus treated by internal fixation: a report of two cases[J]. Foot Ankle Int, 1995, 16(3): 164-166. DOI: 10.1177/107110079501600311.
[13] Ahmad R, Ahmed SMY. Fracture of the posterior process of the talus: an unusual injury[J]. BMJ Case Rep, 2009, 2009(12): bcr2006045609. DOI: 10.1136/bcr.2006.045609.
[14] Paulos LE, Johnson CL, Noyes FR. Posterior compartment fractures of the ankle. A commonly missed athletic injury[J]. Am J Sports Med, 1983, 11(6): 439. DOI: 10.1177/036354658301100611.
[15] Park J, Che JH . Talus fracture of the medial tubercle of the posterior process: interposition of the flexor hallucis longus tendon[J]. J Foot Ankle Surg, 2018, 57(3): 615-617. DOI: 10.1053/j.jfas.2017.10.028.
[16] 王正义. 足踝外科学2版[M]. 北京: 人民卫生出版社, 2014: 667-669.
[17] Mao HJ, Shi ZY, Liu ZX, et al. Minimally invasive technique for medial subtalar dislocation associated with navicular and entire posterior talar process fracture: a case report[J]. Injury, 2015, 46(4): 759-762. DOI: 10.1016/j.injury.2014.12.002.
[18] 曾林如, 朱芳兵, 汤样华, 等. 踝后内侧入路双头加压螺钉治疗距骨后突移位性骨折[J]. 足踝外科电子杂志, 2014, 1(2): 112-115. DOI: CNKI:SUN:WKZH.0.2014-02-009.
[19] 张元智, 陆声, 赵建民, 等. 数字化技术在骨科的临床应用[J]. 中华创伤骨科杂志, 2011, 13(12): 1161-1165. DOI: 10.3760/cma.j.issn.1671-7600.2011.12.015.
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