摘要
目的探讨伴有下胫腓联合分离的踝关节骨折的治疗方法。方法回顾分析我院2005年3月～2010年8月手术治疗伴有下胫腓联合分离的踝关节骨折患者39例,骨折复位后,外踝骨折采用钢板坚强内固定,内踝及后踝采用松质骨钉固定。骨折固定后,下胫腓联合用1～2枚皮质骨螺丝钉固定下胫腓联合。术后早期行不负重功能锻炼。术后12周、负重行走前取出固定下胫腓联合的螺丝钉。结果 39例患者获得平均38(5～58)个月的随访,患者骨折部位的疼痛程度(VAS)评分:无痛(0分)32例,轻度疼痛(1～3分)6例,中度疼痛(4～6分)l例。根据AOFAS评分评价术后功能:优30例,良9例,优良率100%。39例患者均未发生下胫腓联合再次分离。结论精确的解剖复位、坚强内固定、早期不负重功能锻炼是提高关节骨折疗效的关键。
Objective To discuss the therapies for malleolar fracture with distal tibiofibular syndesmosis separation.Methods Retrospective analysis the surgery on 39 patients who had malleolar fracture with distal tibiofibular syndesmosis separation from Mar 2005 to Aug 2010.After the reduction of fracture,we gave strong internal fixtion with plate in lateral malleolus,cancellous screw fixtion in medial malleolus and hock,cortical screw to fix the distal tibiofibular syndesmosis separation.After surgery direct patients have non-weight-bearing exercise prophase and 12 weeks before weight-bearing walk remove the screw to fix the distal tibiofibular syndesmosis separation.Results All patients were followed average 38 months（5～58 months）.Based on VAS score to the fracture,32 patients were no pain（score 0） 6 patients were little pain（score 1～3） and only one patient was midrange pain（score 4～6）.We use the AOFAS score system to evaluate the function level,excellent were 30 and good were 9.The good rate was 100%.All patient did not show distal tibiofibular syndesmosis separation again.Conclusion The keys to improve the therapies for malleolar fracture are accurate anatomic reduction,strong internal fixation and non-weight-bearing exercise prophase.
出处
《四川医学》
CAS
2011年第11期1786-1788,共3页
Sichuan Medical Journal
关键词
踝关节
骨折
下胫腓联合
手术治疗
malleolar
fracture
distal tibiofibular syndesmosis
therapy
