腓骨远端干骺端钢板固定外踝和后踝治疗三踝骨折  

Plates for Distal Fibular Metaphysis Used As Buttress Plates to Fix Lateral and Posterior Malleolus for the Treatment of Trimalleolar Fracture

作　　者：赵世昌[1] 宋飒[1] 沈龙祥[1] 张春林[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,上海200233

出　　处：《实用骨科杂志》2011年第10期891-894,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨腓骨远端干骺端钢板用作支撑钢板固定外踝和后踝治疗三踝骨折的疗效及预后。方法 2008年1月至2010年1月,采用腓骨远端干骺端钢板用作支撑钢板固定外踝及后踝治疗三踝骨折23例,男10例,女13例;年龄20～65岁,平均45岁。左侧12例,右侧11例。根据Lange-Hansen分型,Ⅲ、Ⅳ度旋后-外旋型14例,Ⅳ度旋前-外旋型9例。直视下行骨折复位内固定,骨折复位固定顺序为外踝、后踝、内踝、下胫腓联合。术后随访观察骨折愈合及钢板稳定情况。结果所有病例得到随访,随访时间12～36个月,平均28.4个月。患肢均无畸形愈合,无骨不连,无钢板外露、松动、断裂,无伤口感染。根据Baird-Jackson评分系统进行评估,优17例,良4例,可2例,优良率为91%。结论腓骨远端干骺端钢板用作支撑钢板固定外踝及后踝治疗三踝骨折,其操作简便、对骨折固定可靠、踝关节功能恢复满意、并发症少,是治疗三踝骨折的有效方法。Objective To evaluate the efficacy and prognosis of plates for distal fibular metaphysis used as buttress plates to fix lateral and posterior malleolus for the treatment of trimalleolar fracture.Methods From January 2008 to January 2010,23 patients with trimalleolar fracture were treated with plates for distal fibular metaphysis used as buttress plates to fix lateral and posterior malleolus.We fixed the lateral malleolus fractures first,then posterior malleolus,medial malleolus and distal the tibiofibular joint.The patients included 10 males and 13 females,with an average age of 45 years old（20～65 years old）.Of them,the fracture of 12 cases was on the left ankle and 11 cases on the right;According to Lange-hansen classification,14 cases had grade Ⅲ or Ⅳ supination-extorsion and 9 had pronation-extorsion.The bone union and the stability of the implants were observed during the follow-up.Results All the patients were followed up for 28.4 months（12～36 months） averagely.There were no malunion,nonunion,implants exposure,loosening、broken,or incisions infection.According to the scale of Baird-Jackson,of the 23 cases 17 showed excellent results,4 showed good results,and 2 showed general results,and the rate of excellent and good was 91%.Conclusion Plates for distal fibular metaphysis used as buttress plates to fix lateral and posterior malleolus for the treatment of trimalleolar fracture is easy to perform and the fixation is fastness,with satisfying ankle joint function and less complications.It is an effective treatment method for the trimalleolar fractures.

关 键 词：三踝骨折 支撑钢板 内固定 

分 类 号：R683.42[医药卫生—骨科学]