踝关节骨折手术治疗的综合分析
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作者Author单位AddressE-Mail
陈金栋 CHEN Jin-dong 中国人民解放军总医院304临床部骨科,北京100037 Department of Orthopaedics,the 304th Clinical Branch of the General Hospital of PLA,Beijing 100037,China chjdong2004@126.com 
侯树勋 HOU Shu-xun 中国人民解放军总医院304临床部骨科,北京100037 Department of Orthopaedics,the 304th Clinical Branch of the General Hospital of PLA,Beijing 100037,China  
李文锋 LI Wen-feng 中国人民解放军总医院304临床部骨科,北京100037 Department of Orthopaedics,the 304th Clinical Branch of the General Hospital of PLA,Beijing 100037,China  
期刊信息:《中国骨伤》2007年,第20卷,第9期,第592-593页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:探讨手术治疗踝关节骨折的方法,对手术疗效进行回顾性分析并总结临床经验。

方法:随访资料完整的187例踝关节骨折患者作为研究对象,男106例,女81例;年龄13~63岁。按照Lauge-Hansen分型,旋后外旋型131例,旋前外旋型33例,旋后内收型16例,旋前外展型7例。所有病例均行开放复位内固定。

结果:随访时间为6~36个月,平均20个月,骨折愈合时间8~14周。疗效按Leeds临床评定标准进行评定:优159例,良22例,差6例。下胫腓关节固定58例,发生螺钉断裂5例,术后脱位再次手术1例。内、外踝切口表浅感染或坏死14例,无畸形愈合发生。

结论:内固定治疗的关键是恢复踝关节解剖关系,腓骨及下胫腓韧带对踝关节的稳定起重要作用,重视皮肤软组织的处理是提高疗效的重要因素。
【关键词】踝关节  骨折  骨折固定术,内
 
Study on the surgical treatment for ankle fracture
ABSTRACT  

Objective: To report the experience and evaluate the results of surgial treatment for ankle fracture by retrospective analysis.

Methods: One hundred and eighty-seven patients with complete clinical data were reviewed,including 106 males and 81 females,aged 13 to 63 years.According to Lange-Hansen′s classification,131 patients were supination-external rotation type,33 were pronation-external rotation type,16 were supination-adduction type and 7 were pronation-abduction type.All the patients were treated with open reduction and internal fixation.

Results: The average duration of follow up was 20 months (range, 6 to 36 months).The healing time was from 8 to 14 weeks.According to Leeds rating system,good were found in 159,fair in 22 and poor in 6.Fifty-eight patients underwent internal fixation of the distal tibiofibular syndesmosis.Broken screws were found in 5 patients and post-operative dislocation of distal tibiofibular syndesmosis recurred in 1 patient,who underwent re-operation.Superficial wound infection or necrosis occurred in 14 patients.No malunion developed in all the patients.

Conclusion: Anatomical reduction is the key of internal fixation.Fibula and distal tibiofibular syndesmosis plays an important role in the stablization of ankle joint.Appropriate soft-tissue management can improve the final results.
KEY WORDS  Ankle joint  Fractures  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:陈金栋,侯树勋,李文锋.踝关节骨折手术治疗的综合分析[J].中国骨伤,2007,20(9):592~593
英文格式:CHEN Jin-dong,HOU Shu-xun,LI Wen-feng.Study on the surgical treatment for ankle fracture[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(9):592~593
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