旋前、后外旋型踝关节骨折下胫腓联合治疗与康复

The treatment and rehabilitation of infra-tibiofibular joint in pronated and supinated and external rotation ankle fracture

目的探讨分析如何提高对Ⅲ、Ⅳ度旋前、后外旋型踝关节骨折下胫腓联合治疗的手术疗效。方法回顾分析62例Ⅲ、Ⅳ度旋前、后外旋型踝关节骨折下胫腓联合损伤的手术及康复方法与随访效果。结果随访62例,时间2-6年,平均3.5年。疗效优良:46例(74.2%)、可:13例(21%)、差:3例(4.8%),优良率为73.8%。结论辅助早期功能锻炼是治疗Ⅲ、Ⅳ度旋前、后外旋型踝关节骨折的关键。

Objective To report the long - term observation of treatment of infra - tibiofibular joint in pronated and supinated and external rotation ankle fracture. Methods A retrospective analysis of the long - term result and surgical methods used to treat 62 patients with infra- tibiofibular syndesmosis in pronated and supinated and external rotation ankle fracture. With the use of fluoroscopic machine, reducing and fixing the external malleolus at first, then fixing the infra - tibiofibular syndesmosis and fixing the internal malleolus at last. When the fracture area of post - malleolus is larger than one fourth of the articular surface, a screw should be used to fix the fracture. Results The followed up period varied from 2 years to 36 years, with an average of 3.5 years. The treatment effectiveness for patients were excellent （46）, good （13）, fair and poor （3）, respectively. The total percentage of good to excellent clinical effects was 73.8 %. Conclusion Early diagnosis, early operation, anatomic reduction, recovering stability of ankle joints, fixing the infra- tibiofibular syndesmosis and early exercising is the key to treat injury of infra - tibiofibular joint in pronated and supinated and external rotation ankle fracture.