手法复位经皮一根针固定外踝治疗不稳定型踝部骨折临床观察

THE TREATMENT OF UNSTABLE ANKLE FRACTURE WITH MANUAL CLOSED REDUCTION AND PERCUTANEOUS SINGLENAIL FIXATION OF LATERAL MALLEOLUS: An Clinical Observation

采用闭合手法复位，经皮一根针胫骨下段前内侧穿入固定外踝的方法治疗不稳定型踝部骨折１００例。获得６～７４个月随访的６８例中，按国家中医管理局１９９４年６月２８日发布的中医病症诊断疗效标准评定，治愈６１例，好转７例。认为踝部解剖复位的根本是整复和固定外踝。本法具备了闭合手法复位损伤小、痛苦少和切开复位内固定对位好、固定牢的优点，克服了保守治疗易错位、固定时间长和切开手术损伤大、并发症多之不足。可早期进行关节功能锻炼。

ne hundred cases of unstable ankle fracture were treated with manual closed reduction and percutaneous singlenail inserting into the anteromedial distal tibia for fixating the lateral malleolus. The results of 68 cases followed up for 6-74 months were evaluted according to the TCM diagnostic and therapeutic criteria laid down by the State Administration of TCM on June 28, 1994, and included cure of 61 cases and improvement of 7. The manipulative reduction and fixation of lateral malleolus are regarded as the key of the anatomical reduction of the ankle. This method has some advantages, such as little injury and little patients suffering of closed manual reduction, and good alignment and rigid fixation of open reduction and internal fixation, and functions to overcome easy displacement and long time fixation as the shortcomings of the conservative treatment, and large injury and many complications as the shortcomings of the surgical. Early functional exercises of the joint may be allowed, and fracture healing and joint functional recovery benefited as well.