手术治疗外展外旋力所致踝关节骨折

Operetive treatment of external rotation. abduction fracures of the ankle

手术治疗外展外旋力引起的踝关节骨折３５例，平均随访２年半，满意率为８８．６％。效果不佳者与软组织损伤严重和关节软骨受损有关。恢复腓骨的长度对防止距骨移位与倾斜十分重要。用钢板固定外踝时要使其下端适应腓骨下段的外翻角。下胫腓联合不论是完全还是不全分离，都应用螺钉固定，以增加踝关节稳定性，早期练习活动。三角韧带断裂时，只要腓骨解剖复位与坚强固定，三角韧带可不予修复。对小于胫骨远端关节面２５％的后踝骨折可不予处理。

Thirty five cases of ankle fracture caused by external rotation abduction force were operated.The average follow-up was 2.5 years,the rate of satisfactory being 88.6%.The most severe soft tissue injuries and damage to the articular cartilage resulted in less satisfactory results.Restoration of the fibular length was important to prevent talar shift and tilt.During steel plate fixation of lateral malleolus,the lower end should fit enersion of lower segment of the fibula.No matter whether the disruption of the syndesmosis was complete or incomplete,the suprasyndesmotic screw was necessary to increase hte stability of ankle joint.Early exercise is necessary.Repairment of ruptured deltoid ligment is not necessary,if fibula is anatomical reducted and rigid fixed.The posterior malleolar fracture,no treatment is required if it involved less than 25% of distal end of tibia.