带筋膜髂骨块移植修复外踝缺损的临床研究  

Clinical analysis of ilium with fascia grafting for reconstruction of complex lateral malleolus defect

作　　者：袁大为[1] 关鹏飞[1] 陈杰[1] 王丙刚[1] 刘英[1] 杨佐明[1] 魏亚恒[1] 

机构地区：[1]唐山市第二医院创伤科,河北063000

出　　处：《中国骨与关节损伤杂志》2015年第4期378-380,共3页Chinese Journal of Bone and Joint Injury

基　　金：唐山市科学技术研究与发展指导计划(13130244b)

摘　　要：目的观察采用带筋膜髂骨块移植修复下胫腓联合平面及其下方外踝缺损的临床疗效。方法回顾性分析自2006-06—2013-08采用带筋膜髂骨块移植修复下胫腓联合平面外踝缺损12例,其中合并下胫腓联合平面下方缺损2例。结果术后12例切口愈合好,随访时间11~26个月,平均17.5个月。X线片显示植骨全部愈合,愈合时间2.6~4.3个月,平均3.5个月;骨块无旋转、移位情况,踝穴间隙基本正常,无感染和创伤性关节炎表现。踝关节活动度正常7例,轻度受限3例,中度受限2例。末次随访时踝关节功能Kaikkonen评分：4例100分,3例95分,3例90分,2例85分,平均93.7分。结论带筋膜髂骨块移植修复下胫腓联合平面及其下方外踝缺损是一种有效方法 。Objective To investigate the clinical effect of the ilium with fascia grafting for reconstruction of the lateral malleolus defect of distal tibiofibular syndesmosis level and below. Methods Twelve patients with lateral malleolus defect of distal tibiofibular syndesmosis treated by grafting the ilium with fascia from June 2006 to August 2013 were retrospectively analyzed. There were two patients with lateral malleolus defect below the distal tibiofibular syndesmosis. Results All of 12 cases obtained the effective follow-up, the follow-up time ranged from 11 to 26 months, the average time was 17.5 months.All of the fractures healed. The healing time ranged from 2.6 to 4.3 months, the average time was 3.5 months. The X-ray showed that the defect region had no rotation and dislocation, no infection and traumatic arthritis. The range of motion in ankle joint was normal in 7 cases, mildly limited in 3 cases, moderately limited in 2 cases. According to the evaluation of the Kaikkonen system： 100 points in 4 cases, 95 points in 3 cases, 90 points in 3 cases, 85 points in 2 cases, the average score was 93.46 points. Conclusion Grafting the ilium with fascia is an effective method to reconstruct the lateral malleolus defect of distal tibiofibular syndesmosis level and below.

关 键 词：外踝 骨缺损 下胫腓联合 骨移植 带筋膜髂骨块 

分 类 号：R687.3[医药卫生—骨科学]