改良踝关节后外侧入路治疗三踝骨折

Modified Posterior-lateral Approach of Ankle in Treatment of Cotton Fracture

目的：评价改良的踝关节后外侧入路在治疗三踝骨折中的效果方法：通过新鲜成人尸体标本的解剖了解该入路的解剖层次以及重要的血管神经结构;临床应用该入路治疗三踝骨折的病人,评价临床效果。结果：该手术入路对后踝及外踝显露充分,同时可向近端延伸显露腓骨,向下延伸显露踝关节后方。手术野中仅有小隐静脉和腓肠神经走行。临床治疗三踝骨折病人5例,后踝和内踝骨折均达到解剖复位,所有病人均获随访3个月-1年。无切口感染及皮肤坏死等并发症发生。骨折于术后16周内均达到骨性愈合。根据Baird-Jackson评分评价疗效：优4例,良1例。结论：改良的踝关节后外侧入路治疗三踝骨折具有显露充分,固定确实的优点,临床效果优良。

Objective： To evaluate the clinical effect of the modified posteriolateral approach in cotton fracture. Method： Anatomy research of the modified ankle posteriolateral approach and use the approach treat real cotton fracture patients. Results： The posteriolateral approach has good view of fractures of posterior malleolus and lateral malleolus and only the saphaneous vein and nerve should be protected, utilize the approach to treat 5 patients of cotton fracture, all has the anatomical reduction of the fractures and no complications happen, according to baird-jackson scoring system ,4 excellent and 1 fairly good. Conclusion： The modified posteriolateral approach of ankle might have good expose of posterior malleolus and lateral malleolus and utilize this approach to treat cetton fractures might have fairly good clinical effects.