内固定外踝骨折并下胫腓分离弧翼状钢板的研制及应用

Research and Application of Pterygoid Steel Plate for Internal Fixation of Fracture of the Lateral Malleolus Associated with Isolation of the Inferior Tibiofibular Joint

研制异形钢板，手术时既能复位、固定外踝骨折，又能用以治疗下胫腓骨分离。方法：钢板两侧伸出弧形翼，以合抱腓骨下段螺旋骨折的两断端。中间一孔可供螺钉穿入，从腓骨经下胫腓韧带联合到胫骨拉紧，以修复下胫腓损伤所致的分离、距骨外移。四角爪棘起嵌抓作用，可防止钢板转动和腓骨短缩。临床治疗用于３２例患者，内踝、后踝骨折仍沿用传统治疗手段。术后两周开始踝关节功能锻练，３～６个月去除内固定。结果：单就外踝骨折及下胫腓分离的处理手术时间平均需１５分，失血微量、无需特殊器械。达解剖位者２８／３２（８７．５％），达Ｐｈｉｌｌｉｐｓ提出的复位标准者４／３２（１．５％）。随访平均２５个月，踝关节功能良好３０／３２例（９３．７５％），功能一般者２／３２例（６． ２％）。结论：弧翼钢板的特别形状针对特殊类型骨折，操作简捷，复位满意、固定确切。

To research a heteromorphic steel plate which was in use of reduction and fixation of the fracture of the lateral malleolus and treatment of the isolation of inferior tibiofibular joint. Method: Pterygoid process of the steel plate stretched bilaterally to hold two broken ends Of spiral fracture of the distal end of the fibula. There was a hole in middle of the plate into which was placed a screw to pull the fibula to the tibia tightly so as to repair the isolation of the inferior tibiofibular joint and lateral shift of the talus. There was a process in each corner of the plate. The process was of anchoring action to prevent the steel plate from rotating and to prevent the fibula from shortening. Result: It averagely took 15 minutes to do the operation for treating the fracture of the lateral malleolus and isolation of inferior tibiofibular joint. No special tool was needed. 87. 5% (28/32) cases achieved anatomic reduction. 12. 5% (4/32) cases achieved the Phillips reduction standard. all cases were followed up for 25 months. 93. 75 % (30/32) cases restored a normal function of the ankle joint. 6. 25 % (2/ 32)cases lost less than one third function of movement. movement Conclusion: Pterygoid steel plate was applied to treating special type of fracture. This steel plate also had following characters: easy to be operated; saving the; satisfactory of reduction and sound in fixation.