踝关节骨折脱位的治疗  

Treatment of ankle joint fracture and dislocation

作　　者：杨立辉[1] 石维强[1] 安立琨[1] 周健[1] 

机构地区：[1]中国铁道建筑总公司总医院骨科,北京100043

出　　处：《实用骨科杂志》2001年第6期423-424,共2页Journal of Practical Orthopaedics

摘　　要：目的：分析总结踝关节骨折脱位治疗要点。方法：对随机抽取的３９例踝关节骨折脱位治疗情况进行分析，随访９个月～３年。采用齐斌评分标准评定临床疗效。结果：非手术治疗１２例，优８例（６６．７％），良４例（３３．３％），优良率为１００％。手术治疗２７例，优１８例（６６．７％），良８例（２９．２％），差１例（４．１％），优良率为９５．９％。结论：（１）松质骨加压螺钉在踝关节骨折治疗中具有固定可靠、操作简单的特点。（２）踝关节骨折治疗中应使骨折解剖复位，并注意下胫腓关节间隙距离，恢复踝穴和距骨的解剖关系是极为重要的治疗标准。（３）外踝是一个关键性结构，外踝骨折务必达到准确的解剖复位和稳妥的固定。Objective: To sum up the experience in the treatment of fracture and dislocation of the ankle joint. Methods: 39 cases of fracture and dislocation of ankle joint randomly chosen were fo1lowed up from 9 months to 3 years. According to Qi Bin grading standard,their clinical treatment results were assessed. Results:Nonsurgical treat- ment was performed on 12 patients with an excellent result in 8 cases (66. 7% ),good in 4 cases (33. 3% ). Excellent and good results were 100%. Surgical treatment was given to 27 cases with an excellent result in 18 cases (66. 7% ), good in 8 cases (29. 2% )and poor in 1 case (4.1 % ). Excellent and good results were 95. 9%. Conclusion: Cancellated bone screw possesses characteristic of firm fixation and uncomplicated operation in the treatment of ankle joint frac- ture and dislocation. Anatomic reduction of the talus was very important,and when the space between the distal tibia and fibula was widened, the syndesmosis separation should be managed. Lateral ma1leolus must reach a correct restoration and firm fixation.

关 键 词：踝关节骨折脱位 骨折治疗 骨折外部复位 关节内骨折 

分 类 号：R683.42[医药卫生—骨科学]