Objective:To compare the differences of radiographical and functional outcomes between traditional and minimally invasive approach in treating Hawskins type Ⅱ fractures of the talar neck. Methods:From February 2000 to February 2008,37 patients underwent reduction and internal fixation using two different approaches. In minimally invasive approach group, there were 16 males and 2 females, ranging in age from 20 to 47 years, averaged (35.2±3.1) years; and in traditional approach group, there were 15 males and 4 females, ranging in age from 22 to 44 years, averaged (35.3±2.3)years. All the patients had Hawskins type Ⅱ fractures. The following data were compared between two groups: operation time, blood loss,length of incision and function of ankle joint. All the patients were graded by Hawkins points-scoring system after operation. Results: All patients were followed up. The duration ranged from 2 to 10 years,with an average of 5.6 years. The index such as operation time, blood loss and the length of incision of patients in minimally invasive approach group were significantly less than those of patients in traditional approach group. According to AOFAS points-scoring system, the score of minimally invasive group was higher than that of traditional approach group. Conclusion:Compared with traditional approach,minimally invasive approach can protect blood supply better, get better clinical effects, which is worth of choosing to treat Hawskins type Ⅱ fractures of talar neck.%目的:比较微创手术与传统术式治疗HawkinsⅡ型距骨颈骨折的临床疗效.方法:2000年2月至2008年2月,分别应用切开复位空心钛钉内固定和闭合复位经皮后外侧空心钛钉内固定治疗37例距骨颈骨折患者.传统术式组:男15例,女4例;年龄22～岁,平均(35.3±2.3)岁;微创组:男16例,女2例;年龄20～47岁,平均(35.2±3.1)岁.按Hawkins分型,均为Ⅱ型.比较两组病例的手术时间、术中出血量、手术切口长度及术后踝关节功能及影像学结果.结果:37例均获随访,时间2～10年,平均5.6年.手术时间、术中出血量、手术切口长度比较,微创组低于传统术式组.按AOFAS疗效标准评分:微创组高于传统组.结论:微创方法较传统手术治疗HawkinsⅡ型距骨颈骨折能更好地保护距骨血运,提高治疗效果,可作为治疗HawkinsⅡ型距骨颈骨折的方法之一.
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