自体趾长伸肌腱修复下胫腓联合损伤的临床体会  

The Construct of Toes Long Extensor Tendon in Treating Inferior Tibiofibular Ligament Damage

作　　者：贾福[1] 白力承 孙瑞芬[2] 

机构地区：[1]昆明医科大学附属延安医院,云南昆明650001 [2]云南中医学院

出　　处：《中国伤残医学》2015年第9期6-7,共2页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨行下胫腓联合韧带损伤的临床特点及手术方法，为临床治疗下胫腓联合韧带损伤疾病提供一种新的思路。方法：对60例行常规切开复位内固定术＋部分趾长伸肌腱重建术，60例仅行常规切开复位内固定术进行对比观察。结果：随访8-24个月，平均13个月。根据手术时间、骨折愈合时间及Baird和Jackson评分系统进行功能评定（疼痛、关节稳定性、行走能力、跑步能力、踝关节活动范围、踝关节X线测量），重建组中优39例，良14例，可5例，差2例，优良率88．3％；非重建组中优31例，良9例，可14例，差6例，优良率66．6％。重建组疗效明显优于非重建组疗效（P〈0．05）。结论：踝关节骨折合并下胫腓联合损伤行切开复位内固定＋趾长伸肌腱重建下胫腓韧带术具有良好的效果，值得推广。Abstract Objective：To investigate the clinical characteristics and surgical methods of inferior tibiofibular ligament damage, for the clinical treatment the diseases provides a new train of thought. Methods： 60cases open reduction and internal fixation plus part of the foot long extensor tendon revaseularization, 60cases only routine open reduction and internal fixation for comparative observation. Results： ： followed up for 8 ~ 24months, an average of 13months. According to the operation time, fracture healing time and Baird and Jackson sco- ring system for functional assessment （ pain, joint stability, walking ability, running ability, ankle range, ankle joint X - ray measure- ment）, the Results： were excellent in 39 cases, good in 14 cases, fair in 5 cases and bad in 2 cases and good rate of 88.3% in group re- construction, the Results： were excellent in 31 cases, good in 9cases, fair in 14 cases and bad in 6 cases and good rate of 66.6% in group non - reconstruction. Reconstruction group curative effect is superior to the non - reconstruction treatment group （ P 〈 0.05 ）. Conclusion： ankle fractures and inferior tibiofibular ligament damage line open reduction and internal fixation with reconstruction under and toes long extensor tendon has a good effect, is worth promoting.

关 键 词：踝关节骨折 下胫腓韧带损伤 内固定 趾长伸肌腱重建 

分 类 号：R641[医药卫生—外科学]