下胫腓联合损伤的诊治

Diagnosis and treatment for the injuries of lower tibiofibular ligament union

目的:探讨下胫腓联合损伤的诊断及治疗方法。方法:切开复位内固定手术治疗下胫腓联合损伤的踝关节骨折33例。按照LaugeHansen分型:旋后外旋型Ⅳ度8例;旋前外展型Ⅲ度(Dupuytren骨折)4例;旋前外旋型Ⅲ度13例,Ⅳ度8例,其中Maisonneuve骨折4例。结果:随访6个月～4年,平均15个月。根据BairdJackson评分标准对其术后疗效进行评定:优16例,良15例,可2例。结论:下胫腓联合是维系踝关节的重要解剖结构,下胫腓联合损伤影响到踝关节的稳定性时应手术治疗,确保下胫腓联合得到解剖性修复。

Objective:To explore the methods for diagnosis and treatment of the injuries of lower tibiofibular ligament union.Methods:A retrospective study on 33 patients,with injuries of lower tibiofibular ligament union were treated with internal fixation of open reduction.According to the system of Lauge-Hansen,the fractures were classified into supination-external rotation grade Ⅳ in 8 cases,pronation-abduction grade Ⅲ in 4 cases (Dupuytren's fracture),pronation-external rotation grade Ⅲ injury in 13 cases and grade Ⅳ in 8 cases (included Maisonneuve fracture 4 cases).Results:The following-up period was from 6 months to 4 years,with an average of 15 months.All patients were evaluated with Baird and Jackson ankle scoring system,16 cases got excellent result,15 good,2 fair.Conclusion:The lower tibiofibular ligament union is an important anatomical structure of ankle joint.It must be treated by operation if the ankle joint has been unstable after injury.Operative treatment can ensure the lower tibiofibular ligament union obtaining anatomical reparation.