AO-B型踝关节骨折合并下胫腓联合分离手术治疗体会  

Surgical Treatment of AO-B Type Ankle Joint Fracture Combined with Separation of Distal Tibiofibular Syndesmosis

作　　者：彭城[1] 刘智[1] 孙天胜[1] 何红英[1] 郭永智[1] 

机构地区：[1]北京军区总医院全军创伤骨科研究所,北京100700

出　　处：《解放军医药杂志》2013年第5期44-47,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：全军临床高新技术资助项目(2010JXJS007)

摘　　要：目的探讨手术治疗AO-B型踝关节骨折合并下胫腓联合分离的效果。方法回顾分析北京军区总医院2010年1月—2011年12月手术治疗的61例AO-B型踝关节骨折的临床资料,应用美国足踝协会踝与后足功能评分(AOFAS)标准对下胫腓联合固定和非下胫腓联合固定患者术后踝关节功能进行比较。结果本组27例合并下胫腓联合分离,均行下胫腓联合固定。58例获随访,随访时间9～18个月。术后6个月时,27例下胫腓联合固定AOFAS低于31例非下胫腓联合固定(P<0.05);术后12个月两者踝关节功能无明显差异(P>0.05)。下胫腓联合固定患者术后6个月AOFAS低于术后12个月(P<0.01)。结论对AO-B型踝关节骨折,术前、术中准确判断是否合并下胫腓联合分离及损伤程度,选择恰当的手术方式和固定方法,是恢复踝关节正常解剖结构及稳定性的关键。Objective To investigate the effect of surgical treatment of AO-B type ankle fracture combined with separation of distal tibiofibular syndesmosis. Methods Clinical data of surgical treatment of 61 patients with AO-B type ankle joint fracture combined with separation of distal tibiofibular syndesmosis during January 2010 and December 2011 in our hospital was respectively analyzed. Ankle joint functions were compared between patients with the distal tibiofibular syndesmosis fixation and patients without fixation by the American Orthopaedic Foot and Ankle Society （AOFAS） stand- ard. Results In this study, 27 patients with separation of distal tibiofibular syndesmosis underwent tibiofibular syndes- mosis fixation. A total of 58 patients were followed up for 9-18 months. Six months after the operation,the ankle joint functions of 27 patients with tibiofibular syndesmosis fixation were worse than those of 31 patients without fixation （P 〈 0. 05） ; there was no significant difference in ankle joint functions of two groups at 12 months after operation （P 〉 0. 05）. The AOFAS scores of patients with tibiofibular syndesmosis fixation at 6 months after operation were lower than those at 12 months after operation （P 〈 0.01 ）. Conclusion It may be the key points of recovery of normal anatomic structure and stability for ankle joint of AO-B type ankle joint fracture by accurately evaluating whether or not combined with separation of distal tibiofibular syndesmosis and injuries degrees before and during operation, and choosing proper operation and fixa- tion methods.

关 键 词：踝关节 骨折 骨折固定术 内 下胫腓联合分离 功能恢复 

分 类 号：R683.42[医药卫生—骨科学]