旋前型踝关节骨折、脱位的手术治疗  

Operative treatment of pronation fractures and dislocations of the ankle

作　　者：方智敏[1] 詹蓓蕾[1] 何飞熊[1] 

机构地区：[1]衢州市人民医院,浙江衢州324000

出　　处：《中国骨伤》2002年第6期337-339,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的　探讨旋前型踝关节骨折、脱位的手术方法及疗效。方法　本组 6 3例采用切开复位和坚强内固定 ,修复三角韧带 ,恢复踝关节内外侧结构的稳定性。下胫腓联合分离仍不稳定者 ,给予皮质骨螺钉横向内固定 ;后踝骨折块超过关节面 2 5 %者给予整复螺钉内固定。结果　随访 4个月～ 5年。按齐氏疗效评定标准 :优良 5 3例 ,可 7例 ,差 3例 ,优良率 84 %。结论　强调骨折切开解剖复位、坚强内固定的同时 ,应充分重视修复三角韧带、下胫腓前韧带 ,以及恢复下胫腓联合的稳定。Objective To explore the operative methods and curative effect of pronation fractures and dislocations of the ankle Methods All 63 cases were treated by open reduction and firm internal fixation,by repairing of the deltoid ligament and restoration of stability of medial and lateral structures of ankle joint.If separation of the tibio fibular joint was still unstable,transverse internal fixation was adopted with one cortical bone screw.In cases with posterior malleolus fractures with the injured articular surface of above 25%,open reduction and fixation was performed with screw.Results All cases were followed up from 4 months to 5 years,and were evaluated according to the criteria of QI Bin:the results showed excellent in 53,fair in 7 and poor in 3,the rate of excellent results was 84%.Conclusion The authors emphasized that,in order to obtain satisfactory result,open anatomical rеduction and rigid internal fixation must be adopted in the fractures,the deltoid ligament and anterior tibio fibular ligament and stability of distal tibio fibular joint should be treated properly.

关 键 词：踝损伤 骨折固定术 脱位 治疗 

分 类 号：R683.420.5[医药卫生—骨科学]