Objective:To investigate the efficacy of TiRobot navigation combined with ankle arthroscopy in the reduction and internal fixation of Hawkins type Ⅱ talus neck fracture.Methods:From January 2019 to September 2020, a total of 13 patients with Hawkins type Ⅱ talus neck fracture were admitted to Department of Foot and Ankle Surgery, Xuzhou Renci Hospital. They were 8 males and 5 females, with a mean age of 35.8 years (from 22 to 61 years). All fractures were reduced and fixated using TiRobot navigation combined with ankle arthroscopy. Time for fracture reduction assisted by intraoperative arthroscopy, time for internal fixation assisted by TiRobotic navigation, fracture union time and complications were recorded. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was used at the last follow-up to evaluate the functional outcomes.Results:All the operations were finished within 2 hour. The primary screw placement succeeded in all. The time for fracture reduction assisted by intraoperative arthroscopy averaged 52.8 min (from 43 to 66 min) and the time for internal fixation assisted by TiRobotic navigation 43.6 min (from 33 to 55 min). All the patients were followed up for an average 13.3 months(from 12 to 15 monhs). They obtained bony union within 3 months. One patient developed traumatic subtalar arthritis with mild pain and was treated conservatively. None of the patients had complications like incision infection or talus necrosis. The average AOFAS ankle-hindfoot score was 91.0 points (from 83 to 94 points) at the last follow-up.Conclusion:In the reduction and internal fixation of Hawkins type Ⅱ talus neck fracture, TiRobot navigation combined with ankle arthroscopy shows advantages of minimal invasion, accurate reduction and screw placement, and limited complications, leading to fine short-term functional outcomes.
目的 比较第3代微创Chevron-Akin术(MICA)与开放Chevron术治疗轻中度外翻(HV)的临床疗效.方法 2017年7月—2020年2月,46例(共52足)轻中度HV纳入本研究.24足采用MICA截骨术,其中16例联合Akin术;28足采用开放Chevron截骨术,其中12例联合Akin术.比较2组患者的并发症、临床评分及相关影像学参数.结果 2组患者均随访2年以上,微创组的平均手术时间、平均骨愈合时间均短于开放组(P<0.05).微创组中有5例患者出现并发症,包括2例内固定刺激、1例关节僵硬及2例神经损伤,开放组中有9例患者出现并发症,包括6例关节僵硬、1例伤口开裂、2例瘢痕增生.2组总并发症发生率的差异无统计学意义(P>0.05).2组患者术前的围术期资料、影像学参数及临床评估的差异均无统计学意义(P>0.05).2组患者术后矫形效果稳定,临床评分及影像学参数比较差异无统计学意义(P>0.05).结论 MICA与开放Chevron治疗轻中度HV均有良好的疗效,但MICA在缩短骨愈合时间和降低软组织并发症发生率方面更有优势.
