特殊踝关节骨折-单纯后踝骨折的治疗策略  

Treatment strategy of isolated posterior malleolar fracture:a special injury involving the ankle

作　　者：唐波[1] 徐亚风 于鑫[1] 燕晓宇[2] TANG Bo;XU Ya-feng;YU XiN;LAN Xiao-yu(Department of Orthopaedics,The Center Hospital of Taian City,Taian 271000,China;Department of Orthopedics,Sixth People's Hospital,Shanghai Jiaotong University,Shanghai 200233,China)

机构地区：[1]山东省泰安市中心医院,山东泰安271000 [2]上海交通大学第六人民医院骨科,上海200233

出　　处：《中国矫形外科杂志》2019年第2期181-185,共5页Orthopedic Journal of China

摘　　要：[目的]探讨特殊的单纯后踝骨折的临床特点和治疗策略。[方法] 2010年1月～2014年12月,治疗单纯后踝骨折共32例,伤后行踝关节查体及踝关节放射影像、CT及MR检查评价韧带损伤情况及通过CT测量后踝骨块面积比值。对于不稳定单纯后踝骨折,应用带线锚钉系统解剖修复韧带损伤,同时固定后踝骨块。[结果]所有病例至少随访2年,术后1年及2年应用美国足踝外科医师协会踝-后足评分系统(AOFAS)、Olerud和Molander踝关节骨折评分系统(OMAS)评价踝关节功能,差异无统计学意义。术后无韧带松弛不稳及内固定失效松动断裂。所有患者对术后踝关节稳定及功能有较高满意度。[结论]手术固定骨块的同时修复韧带损伤治疗不稳定单纯后踝骨折可获得良好的临床疗效。[Objective] To evaluate the clinical characters and strategy of isolated posterior malleolar fracture. [Methods]Between January 2010 and December 2014, 32 patients with isolated posterior malleolar fracture were surgically treated. Following physical examination, the ankle radiographs, CT scans and MRI were taken to make sure which structures were affected,meanwhile fragment area ratio was measured with morphologic assessments in the CT scans preoperatively. For unstable isolated posterior malleolar fracture, anatomical repair of the ligament with anchor suture and fracture fixation with cannulated screw or mini plate were simultaneously performed. [Result] All patients were followed up at least 2 years. There was no significant difference regarding to AOFAS score and OMAS score between those at 1 year and 2 years postoperatively. No ligament instability and implant breakage or loosening were noted in anyone of them. All patients were satisfied with their improvement in stability and ankle function. [Conclusion] The unstable isolated posterior malleolar fracture should be concurrently treated the fracture fragment and ligament tear to achieve good clinical and functional outcomes.

关 键 词：单纯后踝骨折 临床特点 治疗策略 

分 类 号：R683.42[医药卫生—骨科学]