经皮复合固定治疗踝关节骨折临床研究  

Therapeutic effects of percutaneous compound fixation on fractures of ankle joint

作　　者：苏攀[1] 任志凯[1] 李晓峰[1] 

机构地区：[1]洛阳正骨医院,河南洛阳471002

出　　处：《中国骨伤》2006年第6期323-324,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨经皮复合固定治疗踝关节骨折的疗效。方法:183例踝关节骨折患者,男105例,女78例;年龄13～65岁,平均32岁。按LangeHansen分型,旋后外旋型65例,旋前外旋型48例,旋前外展型33例,旋后内收型23例,垂直压缩型Ⅰ度14例。采用经皮复合固定方法进行治疗。具体方法如下:腓骨下段及外踝骨折采用克氏针经皮从外踝穿入腓骨髓腔固定,后踝骨折块超过关节面1/4者,复位后用2根克氏针经皮固定;内踝骨折用1～2根克氏针经皮固定;下胫腓联合分离用钳夹经皮侧方加压固定或钢针贯穿胫腓联合斜行固定。结果:164例获11～35个月随访,采用Leeds评定标准,优良157例,占95.73%;可7例,占4.27%。结论:经皮复合固定不用切开复位,可使踝关节骨折达到良好的复位和可靠的固定,具有创伤小、手术时间短、骨折愈合快、踝关节功能恢复好等优点,是治疗踝关节骨折的一种理想方法。Objective： To explore therapeutic effects of percutaneous compound fixation on fractures of ankle joint. Methods：Among 183 patients with fracture of ankle joint, 105 were male and 78 were female, ranging in age from 13 to 65 years（ mean 32 years）. According to Lange-Hansen＇s classification ,65 patients were supination-external rotation type ,48 were pronation-external rotation type,33 were pronation-abduetion type ,23 were supination-abduetion type, and 14 were vertical compression type to Ⅰ degree. All the patients were treated with percutaneous compound fixation. For fractures of distal fibular segment and lateral malleolus, Kirsehner pins were applied to penetrate skin from lateral malleolus into fibular medullary cavity, and two Kirsehner pins were used after reduction if there were more lateral malleola fracture fragments exceeding 1/4 area of the articular surface. For fractures of medial and posterior malleolus, one or two Kirsehner pins were applied pereutaneously through fracture terminals;and separation of distal tibiofibular junctures were treated by lateral compressive fixation with clamping or fixation with steel pin running through tibiofiular junctures in oblique position. Results：One hundred and sixty-four patients were followed up from 11 to 35 months. According to Leeds evaluation standards, 157 patients obtained excellent or good results （95.73%） and 7 fair （4. 27% ）. Conclusion： Pereutaneous compound fixation without open is effective to ensure good reduction and reliable fixation for fractures of ankle joint. This method with such advantages as minimal invasion, short operation time, early fracture union, good functional recovery of ankle ioint is an ideal method for the treatment of ankle ioint fractures.

关 键 词：踝关节 骨折 骨折固定术 髓内 

分 类 号：R683.42[医药卫生—骨科学] R683.41[医药卫生—外科学]