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复杂外旋型踝关节骨折中后踝的治疗策略
Hits: 2222   Download times: 353   Received:October 15, 2011    
作者Author单位UnitE-Mail
汤洋 TANG Yang 第二军医大学附属长海医院骨科,上海 200433 Department of Orthopaedics,Changhai Hospital Affiliated to the Second Military Medical University,Shanghai 200433,China  
张春才 ZHANG Chun-cai 第二军医大学附属长海医院骨科,上海 200433 Department of Orthopaedics,Changhai Hospital Affiliated to the Second Military Medical University,Shanghai 200433,China zhangchuncai@vip.sina.com 
章云童 ZHANG Yun-tong 第二军医大学附属长海医院骨科,上海 200433 Department of Orthopaedics,Changhai Hospital Affiliated to the Second Military Medical University,Shanghai 200433,China  
李师火 LI Shi-huo 第二军医大学附属长海医院骨科,上海 200433 Department of Orthopaedics,Changhai Hospital Affiliated to the Second Military Medical University,Shanghai 200433,China  
张欣 ZHANG Xin 第二军医大学附属长海医院骨科,上海 200433 Department of Orthopaedics,Changhai Hospital Affiliated to the Second Military Medical University,Shanghai 200433,China  
付青格 FU Qing-ge 第二军医大学附属长海医院骨科,上海 200433 Department of Orthopaedics,Changhai Hospital Affiliated to the Second Military Medical University,Shanghai 200433,China  
期刊信息:《中国骨伤》2012年25卷,第5期,第430-432页
DOI:10.3969/j.issn.1003-0034.2012.05.019


目的:总结和探讨复杂外旋型踝关节骨折中后踝固定的适应证、手术方法及疗效,阐明后踝骨折解剖复位、坚强内固定的重要性。

方法:2007年7月至2009年6月内固定治疗后踝骨折32例,男21例,女11例;年龄19~68岁,平均36岁。按照Lauge-Hansen分型,旋前外旋型Ⅳ型13例,旋后外旋型Ⅲ型7例,旋后外旋型Ⅳ型12例。术后早期功能锻炼,同时定期随访,对踝关节功能恢复进行评定。

结果:32例患者均获随访,时间7~20个月,平均14.5个月,所有骨折获得骨性愈合。疗效评定按照美国足踝骨科协会(AOFAS)推荐的足踝评分系统评分如下:优(90~100分)23例,良(80~89分)7例,可(70~79分)2例,差(<69分)0例。

结论:后踝骨折良好的复位、坚强的固定及早期功能锻炼对踝关节功能恢复、降低创伤性关节炎的发生具有重要意义。
[关键词]:踝关节  骨折  骨折固定术,内
 
Surgical treatment for posterior malleolus in complicated external rotation ankle fracture
Abstract:

Objective:To evaluate the indications,surgical techniques and clinical effects of the fixation of posterior malleolus in complicated external rotation ankle fractures and illuminate the importance of anatomical reduction and rigid internal fixation of posterior malleolar fracture.

Methods:From July 2007 to June 2009,32 patients were treated with open reduction and internal fixation,involving 21 males and 11 females with an average age of 36 years old(ranged from 19 to 68 years old). According to Lauge-Hansen classification:13 cases of pronation-external rotation type(Ⅳ),7 and 12 cases of supination-external rotation type(Ⅲand Ⅳ). Postoperative functional exercise and regular follow-up were done and outcomes were assessed.

Results:All the patients were followed up,and the duration ranged from 7 to 20 months,with an average of 14.5 months. According to Ankle Hindfoot Clinical Rating System of the American Orthopaedic Foot & Ankle Society(AOFAS),23 patients got an excellent result,7 good,2 fair,0 poor.

Conclusion:Anatomical reduction and rigid internal fixation of posterior malleolar fracture as well as early functional exercise have significance in restoring ankle joint function and reducing the incidence of traumatic arthritis.
KEYWORDS: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:汤洋,张春才,章云童,李师火,张欣,付青格.复杂外旋型踝关节骨折中后踝的治疗策略[J].中国骨伤,2012,25(5):430~432
英文格式:TANG Yang,ZHANG Chun-cai,ZHANG Yun-tong,LI Shi-huo,ZHANG Xin,FU Qing-ge.Surgical treatment for posterior malleolus in complicated external rotation ankle fracture[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(5):430~432
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