摘要
目的探讨关节镜辅助下手术治疗合并下胫腓联合分离的踝关节骨折脱位的疗效。方法自2000年3月～2005年3月在关节镜辅助下手术治疗合并下胫腓联合分离的踝关节骨折脱位患者37例，根据AO-Weber分型：B型11例，C型26例。通过关节镜修整软骨缺损的关节面，取出游离体，1／3管型钢板固定外踝，螺钉固定骨折的内踝和后踝。在关节镜监视下准确复位仍有残存不稳的下胫腓联合，并用螺钉固定。结果所有患者获得14～36个月（平均21．4个月）随访，骨折愈合时间11～15周，平均13周。无感染、断钉及下胫腓联合再分离等并发症，根据AOFAS评分：优23例，良10例，可或差4例，优良率为89.1％。结论通过踝关节镜可更准确判断下胫腓联合的稳定性，并更精确地将其复位、固定，操作简便，疗效可靠。
Objective To study arthroscopically assisted treatment of ankle joint fracture and dislocation combined with inferior tibiofibular joint disruption. Methods Thirty-seven patients were treated with assistance of arthroscopy from March 2000 to March 2005 for their ankle joint fracture and dislocation combined with inferior tibiofibular joint disruption. According to Weber classification system, there were 11 cases of type B and 26 cases of type C. Cartilage-defected areas were trimmed, cartilaginous fragments removed, lateral malleoli fixed by 1/3 cast plate, internal malleoli and ventral condyles fixed by screws, and at last inferior tibiofibular joints exactly reduced under arthroscopic monitoring and firmly fixed by screws. Results The average follow-up was 21.4 months. Fractures healed from 11 to 15 weeks, with an average of 13 weeks. No such complications as infection, nail breaking, re-disruption of inferior tibiofibular joint happened. According to the AOFAS score system, 23 cases got excellent results and 10 good results. The good and excellent rate was 89. 1%. Conclusions Ankle arthroscopy can lead to accurate estimation of the stability of injured inferior tibiofibular joint and exact reduction and fixation of the joint. Moreover, it is an easy and reliable ooeration.
出处
《中华创伤骨科杂志》
CAS
CSCD
2007年第9期824-826,共3页
Chinese Journal of Orthopaedic Trauma
关键词
关节镜
踝关节
骨折
下胫腓联合分离
Arthroseopy
Ankle-joint
Fracture
Inferior tibiofibular joint disruption
