经皮钳夹固定治疗踝部损伤下胫腓联合分离

Clamping fixation for ankle injuries with distal tibiofibular syndesmosis dissociation

采用牵引下内翻或内旋位逆损伤方向手法复位，付氏钳夹固定的方法治疗踝部损伤下胫腓联合分离３０例。经６～３６个月随访，结果优良率为９６．７％。观察认为，下胫腓联合分离多为踝部骨折并发，由外翻暴力或外旋暴力所致。Ｘ线片下胫腓间隙增宽大于３ｍｍ，结合临床症状即可确立诊断。手法复位后采用钳夹经皮固定，钳尖顶压在内外踝上，直接通过内外踝施压于下胫腓联合，作用力直接，固定牢靠，是治疗下胫腓联合分离简便有效的固定方法，利于早期功能锻炼。

Thirty cases of ankle injuries with distal tibiofibular syndesmosis dissociation were treated by manual redution and clamping fixation With an excellent-good rate of 96.7% shown through a 6-36-month follow-up.Distal tibiofibular syndesmosis dissociation is associated with ankle injuries and caused by eversion or extorsion violence. The dissociation can be diagnosed by a 3-mm widening of the distal tibiofibular syndesmosis on the x-ray films and clinical symptoms.After l reduction,clapming fixation was percutaneously made.Two tips of the fixator directly camp and compress the lateral and medial malleoli as well as the syndesmosis. With its t forces,the method can produce rigid fixation and benefitsearly functional exercises,being a simple and effective fixating method of the injury