41例旋后外旋型踝关节骨折手术治疗体会

The experience in the treatment of supinated and external rotationed ankle fracture.

目的 探讨分析如何提高旋后外旋型踝关节骨折的手术疗效。方法 回顾分析41例旋后外旋型踝关节骨折的手术方法及随访结果,患者手术时在X光机监视下先复位、固定外踝,再固定下胫腓关节,最后固定内踝,内翻位石膏固定治疗三角韧带损伤。在后踝骨折大于1/3关节面时,行螺钉固定。结果41例患者均得到随访,平均随访时间18月(12～62月),临床疗效优25例(61％),良10例(24.4％),可4例(9.7％),差2例(4.9％)。结论 正确的手术方法可获得较好的临床手术疗效。

Objective To report the long-term observation of the surgical treatment of supinated and external rotationed ankle fracture. Methods A retrospective analysis of the long-term results and surgical methods used to treat the 41 patients with supinated and external rotationed ankle fracture. With the use of fluoroscopic machine, reducing and fixing the external malleolus first, then fixing the infra-tibiofibular joint and fixing the internal malleolus at last. Fixing the ankle joint in Introversion position by plaster to treat the deltoid ligament impairment. When the fracture area of post- malleolus is bigger than 1/3 of the articular surface, a screw should be used to fix the fracture. Result Following-up period ranged from 12 months to 62 months (average 18 months) in 41 patients. The patients were evaluated in regard to function and X-ray film. 25 cases (61%) had excellent results, 10 cases(24.4%) good, 4 cases(9.7%) fair, 2 cases(4.9%) bad. Conclusion The correct surgical technique can achieve good result in the treatment of supinated and external rotationed ankle fracture.