合并下胫腓联合分离的踝关节骨折手术治疗

Surgical treatment of ankle joint fracture combined with separation of distal tibiofibular syndesmosis

目的探讨切开复位内固定治疗合并下胫腓联合分离的踝关节骨折的疗效。方法 52例合并下胫腓韧带损伤的踝关节骨折脱位的患者,采用切开复位内固定,下胫腓联合采用单个或双螺钉固定,手术后用石膏外固定6周。术后根据Baird-Jackson系统评分标准进行疗效评估。结果本组52例患者术后平均随访4.5年(6个月～8年),骨折愈合良好,无切口感染发生。根据Baird-Jackson评定标准,本组优26例,良21例,可3例,差2例,优良率为90.38%。结论骨折的解剖复位,胫距之间正常的对合关系,应依据不同骨折类型处理下胫腓韧带损伤,是取得满意结果的关键。

Objective To investigate the effect of open reduction and internal fixation in the treatment of ankle joint fracture with separation of distal tibiofibular syndesmosis.Methods Fifty-two cases of ankle joint fracture with separation of distal tibiofibular syndesmosis had been treated by open reduction and internal fixation combined with fixation of inferior tibialfibular syndemosis with one or two screws and with plaster external fixation for 6 weeks postoperatively.Curative effect evaluation was made according to Baird-Jackson system postoperatively.Results All cases have been followed up for an average 4.5 years（6 months-8 years）.Fracture healing well,no infection had happened in the cases.The outcome was evaluated with Baird and Jackson score system of ankle joint.The results had been excellent in 26 cases,good in 21 cases,fair in 3 cases and poor in 2 cases,the excellent rate was 90.38%.Conclusion The key points to obtain satisfied results depended on anatomic reduction of fracture,restore of normal mortise and management inferior tibiafibular syndesmosisinjuty based on the fracture pattern.