胫骨远端后内侧解剖接骨板固定后踝治疗三踝骨折

Application of posteromedial anatomy plate of distal tibia fixation of posterior malleolus for trimalleolar fracture

目的探讨胫骨远端后内侧解剖接骨板固定后踝治疗三踝骨折的临床效果。方法2007年2月至2009年1月采用胫骨远端后内侧解剖接骨板固定后踝治疗三踝骨折患者11例,男7例,女4例;年龄23～58岁,平均41岁;左踝5例,右踝6例;开放骨折2例,闭合骨折9例。根据Lauge-Hansen分型均为旋前外旋型Ⅳ度,后踝骨折均超过关节面的25%。结果全部获得随访,随访时间为11～26个月,平均15.8个月。伤口均一期愈合,无一例发生感染。骨折愈合时间为10～15周,平均11.6周。术后采用AOFAS踝关节-后足评分标准,评分为83～100分,平均87.2分。结论胫骨远端后内侧解剖接骨板固定后踝是治疗三踝骨折的有效方法之一。

Objective To investigate therapeutic effects of posteromedial anatomy plate of distal tibia fixation of posterior malleolus on the trimalleolar fracture.Methods Between February 2007 and January 2009,11 patients with tri- malleolar fractures were treated by posteromedial anatomy plate of distal tibia fixation of posterior malleolus.There were 7 males and 4 females with an average age of 41 years（ranged from 23 to 58 years）.Of them,the fracture of 5 cases was on the left ankle and 6 cases on the right;2 suffered from open fractures and closed fractures in 9 patients.They were all gradeⅣpronation-external rotation ankle fractures according to the Lauge-Hansen classification and the posterior malleolus fractures were more than 25%of articular surface.Results All cases were followed up for 15.8 months in average （ranged from 11 to 26 weeks）.The wound healed well,and the mean time of bone union was 11.6 weeks（ranged from 10 to 15 weeks）.No infection was found in all cases.According to the ankle-hindfoot scale of AOFAS,the mean score was 87.2（ranged from 83 to 100）.Conclusion Posteromedial anatomy plate of distal tibia fixation of posterior malleolus may provide satisfactory clinical outcomes for trimalleolar fracture.