创伤性上胫腓关节脱位  

Traumatic dislocation of superior tibiofibular joint

作　　者：方伟松 罗聪 邵汝谊 周建明 石高才 卢焕兴 楼才俊 

机构地区：[1]诸暨市人民医院骨科,浙江诸暨311800

出　　处：《中国骨伤》2012年第7期605-606,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨创伤性上胫腓关节脱位的特点、诊断及治疗。方法:自2000年4月至2010年8月收治的创伤性急性上胫腓关节脱位12例,其中男10例,女2例;年龄18～60岁,平均30.6岁。根据Ogden分型:前外侧脱位8例,后内侧脱位2例,向上脱位2例。患者均表现为膝外下方肿胀,腓骨小头突出,腓骨小头疼痛,按压腓骨小头有浮动感。1例保守治疗,11例手术治疗。结果:12例均获随访,时间10个月～3年,平均18个月。按Lysholm评价标准:跛行(4.92±0.28)分,支撑(4.92±0.28)分,交锁(15.00±0.00)分,不稳定(24.58±0.79)分,疼痛(22.50±1.24)分,肿胀(8.50±0.90)分,爬楼梯(9.75±0.62)分,下蹲(4.92±0.28)分,总分(95.08±2.02)分;优11例,良1例。神经功能均恢复,X线检查无再脱位。结论:创伤性上胫腓关节脱位易漏诊,手术是主要的治疗方法,预后良好。Objective ：To explore the characteristics, diagnosis and treatment on traumatic dislocation. Methods：From April 2000 to August 2010,12 patients with acute traumatic dislocation of superior tibiofibular joint were treated including 10 males and 2 females with an average age of 30.6 years old ranging from 18 to 60 years. According to Ogden classification, 8 cases were the anterolateral dislocation,2 were posterior-medial dislocation,and 2 were upward dislocation. All patients had swelling in lateral-inferior of knee ,fibular head prominent,fibular head pain ,floating feeling in head of fibula. One case was treated by conservative treatment, and the remaining 11 cases by surgical treatment. Results：All patients were followed-up for 10 months to 3 years （means 18 months）. Evaluation by Lysholm scoring,the total scores were 95.08±2.02,involving limbing 4.92±0.28,support 4.92±0.28,interloeking 15.00±0.00,instability 24.58±0.79,pain 22.50±1.24,swell 8.50±0.90,climbing stairs 9.75±0.62,squatting 4.92±0.28; 11 cases achieved excellent results and 1 good. Nerve functional recovered. X-ray was no longer dislocation. Conclusion：The diagnosis of traumatic dislocation is easy misseddiagnosis, surgery is the main treatment method, the prognosis is good.

关 键 词：上胫腓关节 脱位 外科手术 

分 类 号：R684.704[医药卫生—骨科学]