Maisonneuve骨折的诊断与治疗

Diagnosis and Treatment for Maisonneuve Fracture

目的探讨Maisonneuve骨折的诊断方法以及评估手术治疗效果。方法回顾性分析1998年12月～2008年12月,对20例Maisonneuve骨折进行手术治疗,采用1～2枚皮质骨螺钉固定下胫腓联合,内踝骨折用拉力螺钉固定,大于25%的后踝骨折及胫骨远端前外侧骨折(Chaput骨折)应用拉力螺钉固定。采用美国足踝协会踝与后足功能评分(AOFAS)对术后功能进行评定。结果平均随访52个月,骨折均愈合。AOFAS评分平均92.5分,19例优良,1例可。结论 Maisonneuve骨折是一种严重的不稳定性踝关节骨折,由于其骨折的特殊性,容易导致误诊。手术治疗恢复下胫腓正常解剖关系以及踝穴的匹配对预后起决定作用。

Objective To evaluate the diagnosis of Maisonneuve fracture and to assess outcomes in patients treated surgically for Maison- neuve fractures. Methods The outcomes of 20 patients with Maisonneuve fractures which had surgical treated from December 1998 to December 2008 were reviewed. All patients treated surgically, had one or two cortical screws to fix the syndesmosis. Fracture of the medial malleolus was reduced and f＇Lxed with two lag screws. The posterior malleolus fractures that involved 〉25% of the articular surface and the Chaput＇s fracture were Fixed with lag screws. The outcomes were assessed by AOFAS （American Orthopaedic Foot ＆ Ankle Society） scoring scale. Results All patients were reassessed clinically, average foUow-up was 52 months. All eases had fracture healed. The average AOFAS score was 92.5 points. Nineteen patients （95%） had a satisfactory result. One case had a fair result. Conclusion The Maisonneuve fracture is one of the most unstable ankle injuries and is easy misdiagnosis because it＇s specialty. It is critical to prognosis that surgical treatment to reduce and maintain the syndesmosis and to keep ankle mortise congruity.