三踝骨折合并胫距关节脱位的手术治疗

The surgical treatment of trimalleolar fracture and dislocation of tibiotalar area of contact

目的总结三踝骨折合并胫距关节脱位的手术治疗要点。方法回顾分析64例三踝骨折合并胫距关节脱位患者的临床和手术资料,随访6个月～10年,采用苟氏评定标准评定临床疗效。结果优34例、良25例、可5例、差0例,优良率93.7%。结论①对三踝骨折合并胫距关节脱位应采用切开复位内固定治疗。②恢复踝穴和距骨的解剖关系,复位下胫腓联合分离极为重要。③外踝的解剖复位和稳妥固定是治疗的重点。

Objective To investigate the surgical treatment of trimalleolar fracture and dislocation of tibiotalar area of contact. Methods The clinical and operative data of 64 patients admitted between 1995 and 2005 were retrospectively reviewed. Results All cases were followed up for 6 months to 10 years. According to GOU＇S evaluation criterion, the operative outcome was evaluated as excellent in 34 cases, good in 25 cases, fair in 5 cases and poor in 0. The excellent and good rate was 93.7 % .Conclusion Trimalleolar fracture and dislocation of tibiotalar area of contact are treated by open reduction and internal fixation;Anatomic relation of the talus is important for ankle fracture combined with abruption of lower tibiofibular ligament union; Restoring the external malleolus anatomic relation and stable internal fixation are the key points for surgical treatment of trimaUeolar fracture and dislocation of tibiotalar area of contact.