后踝骨折的生物力学分型及临床应用

The Biomechanics Classification and Its Clinical Application of Fracture of Posterior Malleolus(FPM)

目的 对后踝骨折进行分型 ,用于指导临床治疗。方法 入院患者进行物理检查 ,主要是对初次X线片进行测量、归纳 ,4 4例根据手术所见。结果 通过对 175例后踝骨折病例进行分析 ,发现后踝骨折是由于踝关节受到由后向前下的冲力及足剧烈内翻或外翻产生的扭矩应力 ,距骨撞击后踝和下胫腓后韧带牵拉所致。依据 :①后踝骨折的生物力学机制 ;②后踝骨折移位的特点 ;③骨折波及关节面的损伤程度 ;④是否合并周围组织损伤及踝穴的稳定状况 ,将后踝骨折分为四型 ,并应用于临床。应用本分型治疗 175例后踝骨折 ,取得了 95 .6 %的优良率。结论 对后踝骨折实行分型 ,为临床治疗提供了理论依据。

Objective To classify fracture of posterior malleolus(FPM) and guide its clinical treatment.Methods One hundred and seventy five cases were given physical examination,Informations were acquired mainly on the basis of measures and calculations on the first of roentgenograms after fractures,44 cases of them on the basis of that seen during operations.Results FPM were caused by the impulsive force form behind to front and the distorting stress on ankle and the distorting stress when foot is strenuous varus or valgus and the tali strike posterior malleolus and posterior inforior tibiofibular ligaments.FPM were classified into four degrees and corresponding treatments were offered on the basis,as follows:①the biomechanical mechanism of FPM;②the transposing characterization of FPM;③the degrees that fractures injuried articular surface;④if surrounding tissues were injuried and the stable state of mortise.We applied the classification to treat 71 patients of FPM.The rate of excellent and good results was 95.6%.Conclusion To classify FPM and this may provide guidance for clinical treatment.