小腿后外侧入路在后踝骨折及胫骨下段开放性骨折治疗中的应用  

Posterior-lateral approach for fixation of fractures of posterior malleolus and open fracture of distal tibia

作　　者：苏郁[1] 朱建福[1] 王旭[1] 王晓露[1] 刘寿坤[1] 

机构地区：[1]福建医科大学附属闽东医院骨科十区,福安355000

出　　处：《骨科》2013年第4期184-186,共3页ORTHOPAEDICS

摘　　要：目的探讨胫骨下段后外侧人路在胫骨远端开放性骨折及后踝骨折中应用效果。方法2010年3月至2012年4月，共对15例踝关节骨折和6例胫骨下段开放性骨折行手术治疗。踝关节组：男9例，女6例，年龄21．0～58．0岁，平均43．6岁。胫骨下段骨折组：男4例，女2例，年龄31．0～49．0岁，平均36．6岁。所有患者经小腿下段后外侧入路行切开复位内固定术，定期复查。结果所有患者术后获得平均14个月（8～20个月）的随访。伤口均I期愈合，无感染，骨折均已愈合。AOFAS踝关节一后足评分标准，踝关节骨折组：优11例，良3例，可1例。胫骨下段骨折组：优2例，良3例，可1例。结论胫骨下段后外侧入路软组织并发症少，不影响骨折愈合，可以作为胫骨下段开放性骨折治疗方法中一种补充，同时作为后踝骨折，该人路优点突出，可作为手术常规入路。Objective To investigate the curative effects of posterior-lateral approach for fractures of posterior malleolus and open fracture of distal tibia. Methods From March 2010 to April 2012, 15 patients with closed ankle fractures and 6 pa tients with open fracture of distal tibia were treated in our Hospital. The average age of the serial of ankle fracture at the time of injury was 43. 6 years （range 21 to 58 years） and that of the serial of distal tibia fracture was 36. 6 years （range 3l to 49 years）. In all cases posterior-lateral approach was used for both the posterior malleolus fracture and open fracture of distal tibi- a. Results Average follow up period was 14 months （range 8 to 20 months）. All fractures united. The incisions of all patients had primary healing. There were no deep infections. At the latest follow-up, the ankle joint function was excellent in ll cases, good in 3 cases, and fair in 1 case of ankle fracture, and excellent in 2 cases, good in 3 cases, and fair in 1 case of distal tibia fracture according to the AOFAS standard. Conclusion Posterior-lateral approach has few complications and does not affect the healing of fracture. It can be used as a supplement to the treatment of the open fracture of the distal tibia, and as a surgical conventional approach in posterior malleolus fracture.

关 键 词：胫骨骨折 踝损伤 骨折 开放性 

分 类 号：R687.3[医药卫生—骨科学]