三踝骨折32例手术治疗体会  

Surgical Treatment of Trimalleolar Fracture in 32 Cases

作　　者：涂敏[1] 李人杰[1] 雷光华[1] 李宇晟[1] 李康华[1] 

机构地区：[1]中南大学湘雅医院,湖南长沙410008

出　　处：《医学临床研究》2008年第4期630-632,共3页Journal of Clinical Research

摘　　要：[目的]探讨三踝骨折切开复位内固定的手术方法及疗效。[方法]自1999年6月至2006年1月，对32例三踝骨折行开放复位内固定术，术中根据骨折类型，选择手术入路及固定方法。[结果]全部患者均获得随访，随访时间12～43个月，平均22．5个月，骨折愈合时间为12～18周。用Olerud与Monlander评分系统对其疗效进行评定。其中：优18例，良8例，一般4例，差2例，优良率82％。术后未发生感染、骨折畸形愈合和螺钉断裂等。但有1例延迟愈合。[结论]对于复杂的三踝骨折，应首选开放复位内固定，其手术入路，方式与内固定的选择为手术成功的要点。术中应重视韧带的处理，重建三踝的稳定性。[Objective]To study the surgical techniques and results of the open reduction and internal fixation for trimalleolar fracture. [Methods] Thirty two patients with trimalleolar fracture were treated with,open reduction and internal fixation from June 1999 to January 2006. The choose of the surgical approach and fixation methods were accord with the classification of trimalleolar fracture. [Results] The follow-up period varied from 12-43 months with the average of 22.5 months. All the patients were evaluated with Olerud and Monlander scoring system. The number of patients whose results were excellent, good, fair and poor was respectively 18, 8, 4 and 2. The total percentage of good and excellent clinical fractures results was 82%. There were no local complication, malunion of fracture, the deformity of ankle and the broken of the inserted screw. However, the delayed union was observed in one case. [Conclusion] The first choice of the treatment of complex trimalleolar fracture is open reduction and internal fixation, which leads to good clinical results. The fracture pattern and the surgical techniques will also affect the results of the therapy. The reconstruction of the stability of trimalleolar should be emphasized.

关 键 词：骨折/外科学 踝损伤/外科学 

分 类 号：R684.7[医药卫生—骨科学]