三踝骨折合并下胫腓骨联合分离的临床分析

The clinical analysis of trimalleolar ankle fracture combined with abruption of lower tibiofibular ligament union

目的探讨三踝骨折合并下胫腓联合分离的受伤机制、诊断及治疗方法。方法对采取手术切开复位内固定治疗的36例三踝骨折合并下胫腓骨联合分离患者的临床资料进行回顾性分析。手术方式:采用内外踝标准切口,分别对外踝-后踝-外踝-下胫腓联合或者后踝-外踝-内踝-下胫腓联合进行整复。术后鼓励患者早期功能锻炼。结果 36例全部随访,随访时间7～26个月,平均15.7个月。36例骨折均愈合。按Leeds等评定标准:优19例,良14例,差3例,优良率91.7%。结论三踝骨折合并下胫骨联合分离的患者通过手术治疗达到解剖复位,稳定内固定,早期功能锻炼,可以得到满意的效果。

Objective To explore mechanism,diagnosis,treatment of trimalleolar ankle fracture combined with abruption of lower tibiofibular ligament union.Methods The effect of 36 patients with trimalleolar ankle fracture combined with abruption of lower tibiofibular ligament union for operative treatment was analyzed.Standard incisions of medial and lateral malleolus were used in the operations.The order of open reduction and internal fixation was Lateral malleolus-back malleolus-medial malleolus or back malleolus-lateral malleolus-medial malleolus.Patients were encouraged to exercise early.Results 36 cases were followed up for 7 month ～26 month（the average of 15.7 month）.All the patients get healed.According to Leeds＇standard of ankle joint,excellent ： 19 cases,good ： 14 cases;poor ： 3 cases.The total percentage of good to excellent clinical results was 91.7%.Conclusion The patients with trimalleolar ankle fracture and abruption of lower tibiofibular ligament union can get the most benefit from anatomical reposition,firm fixation by operating and exercise early.