记忆合金弓齿钉处理踝关节骨折中的下胫腓联合分离

Treatment of syndesmosis diastasis with shape memory staple fixation in ankle fractures

目的:探讨踝关节骨折合并下胫腓联合分离的手术方法。方法:自2009年1月至2011年12月,对采用记忆合金弓齿钉固定治疗的24例下胫腓联合分离患者的临床资料进行回顾性分析,其中男10例,女14例;年龄19～71岁,平均43岁。所有患者结合病史、查体及影像学检查进行诊断,按Lauge-Hansen分型进行手术治疗。术后按照美国骨科足踝外科医师协会(AOFAS)评分标准进行功能评价。结果:24例均获得随访,时间6～28个月,平均16个月,所有骨折获愈合,愈合时间8～14周,平均9.2周。术后AOFAS评分为(87.50±13.16)分。1例并发创伤性关节炎,无断钉及内固定失效,临床疗效优16例,良5例,可2例,差1例。结论:记忆合金弓齿钉处理踝关节骨折并发的下胫腓联合分离,不仅能保留踝关节及下胫腓联合的生理活动,且负重前无须常规取出,是一种值得推广的治疗方法。

Objective：To explore operative method in the treatment of syndesmosis injury of ankle fractures. Methods： Twenty-four patients with ankle fractures and syndesmosis diastasis were treated with shape memory fracture staples, including 10 males and 14 females ranging in age from 19 to 71 years,with an average of 43 years. All patients were diagnosised with history, body examination and image data and were operated according to classification of Lauge-Hansen. Results： All patients were followed up from 6 to 28 months with an average of 16 months,and all fractures healed,with a mean time 9.2（8 to 14） weeks. Only one case had radiological and clinical manifestations of traumatic arthritis, but no breakage of shape memory frac- ture staple in all cases. Sixteen patients got excellent results, good in 5, fair in 2, poor in 1. Conclusion：Shape memory staple fixation for the treatment of syndesmosis diastasis in ankle fractures not only can perseve the physical motion of ankles, but also be remove earlier before weight bearing.