不同内固定方式对踝关节骨折的疗效分析  

Analysis of different methods of internal fixation of ankle fractures

作　　者：王良恩[1] 邱志杰[1] 徐红革[1] 杨勇[1] 杨斌[1] 

机构地区：[1]四川省眉山市人民医院骨二科,620020

出　　处：《中国综合临床》2013年第8期853-855,共3页Clinical Medicine of China

摘　　要：目的探讨不同内固定方式对踝部骨折的治疗效果。方法150例踝关节骨折患者手术治疗并采用单纯克氏针交叉固定、普通螺丝钉髓内固定、松质骨加压螺丝钉固定、4孔普通钢板固定、张力带固定5种不同内固定方式。随访并采用美国足踝外科协会后足评分系统进行评分，观察患者术后恢复情况及并发症的发生情况。结果150例患者分别进行12～24个月的随访，平均随访时间为19个月，预后优29例，良65例，可44例，差12例，手术治疗的优良率为62．6％（94／150）；手术后骨折不愈合I例，骨折畸形愈合6例，创伤性关节炎7例，伤口疼痛10例，术后并发症的发生率为16．0％（24／150）；术后发生浅层感染10例，深层感染5例，有严重皮肤刺激感11例，术后感染的发生率为17．3％（26／150）。结论手术治疗踝关节骨折5种不同的内固定方式对踝关节骨折均有较好的治疗效果。Objective To investigate the treatment effects of different fixation for fracture and dislocation of ankle joint and to sum up the experience for clinical treatment. Methods One hundred and fifty patients with fracture and dislocation of ankle joint using 5 different internal fixation surgeries were involved with this research：simple cross Kirschner wire fixation, intramedullary fixation ordinary screws, cancellous lag screw fixation,4 holes common plate fixation, tension band fixation. Patients were followed up and evaluated by the American Orthopedic Foot and Ankle Society Score for scoring, and investigated the postoperative recovery and the occurrence of postoperative infections and complications in patients. Results After followed up from 12 to 24 months with an average follow-up time of 19 months, of 150 patients, there were 29 cases with excellent result,65 cases with good result,44 cases with general and 12 cases with poor result,the excellent and good rate was 62. 6% （94/150）. One case with nonunion,6 cases with malunion,7 cases with traumatic arthritis, 10 cases with wound pain, the incidence of postoperative complications was 16. 0% （24/150）. There were 10 cases with shallow infection, 5 cases with deep infection, and 11 cases with severe skin irritation; The incidence of postoperative infection was 17.3% （26/150）. Conclusion Surgical treatment is the main treatment of fracture and dislocation of ankle joint, 5 different methods of internal fixation of ankle fractures had good therapeutic effect.

关 键 词：踝关节骨折 内固定 外科手术 

分 类 号：R687.3[医药卫生—骨科学]