腓骨中上段骨折对踝关节生物力学影响的临床研究  

Biomechanical effect of mid-upper fibular fracture on ankle joint

作　　者：谢新敏[1] 李来峰[1] 赵学春[1] 李强[1] 刘华水[1] 布金鹏[1] 张太元[1] 

机构地区：[1]济南市第三人民医院骨科,250101

出　　处：《中国矫形外科杂志》2009年第14期1081-1083,共3页Orthopedic Journal of China

摘　　要：[目的]探讨有移位的腓骨中上段骨折对踝关节力学的影响,并为有移位的腓骨中上段骨折应进行有效内固定提供理论支持。[方法]选取本院2005年1月-2006年6月收治的有移位的腓骨中上段骨折病人20例,拍摄双侧踝关节标准正位片,测量踝穴宽度、腓骨远端上移之数值,来观测对踝关节稳定性的影响;应用foot-scan足底压力分析仪,检测足底压力中心轨迹,距下关节角度范围,进行健患侧对比。[结果]有移位的腓骨中上段骨折,畸形愈合后,会导致踝穴增宽、外踝上移[(平均值分别为(1.260±0.339)mm;(1.045±0.276)mm],致使踝关节稳定性下降。有移位的腓骨中上段骨折,足底压力分析,足底压力中心轨迹偏移,距下关节角度范围比健足明显增大(P<0.01),即足踝部存在不稳。[结论]有移位的腓骨中上段骨折应解剖复位并进行有效内固定,恢复踝关节稳定性。[ Objective ] To investigate the biomechanical effect of mid-upper fibular fracture on ankle joint. [ Method ] From January 2005 to June 2006,20 cases of mid-upper fibular fracture were collected. Normal anterior film of bilateral ankle joint was photographed, ankle mortise width and distal fibula upper shift were measured to observe the effect on stability of ankle joint. Footscan pressure analyzer was used to detect the central track of footplate pressue, subtalar joint angle, in order to compare the difference between normal ankle and the sick. [ Result] Dislocated mid-upper fibular fracture could lead to ankle mortise widening,lateral malleolus up shift （ averaged, 1. 260 ±0. 339mm, 1. 045 ±0. 276mm）. the central track of footplate pressure offset and the fracture sides subtalar joint angle were larger than those in normal feet（ P 〈 0.01 ）. [ Conclusion] Dislocated mid-upper fibular fractures should be effectively internal fixed to recover the stability of ankle joint.

关 键 词：腓骨中上段骨折 踝关节 生物力学 足底压力分析 

分 类 号：R683.4[医药卫生—骨科学]