经外踝钢板双螺钉交接棒技术内固定治疗下胫腓联合损伤

Double screw exchange-baton technique for treatment of distal tibiofibular syndesmosis injury

目的探讨经外踝钢板双螺钉交接棒技术内固定治疗下胫腓联合损伤的临床效果。方法自2009-01—2012-06对33例下胫腓损伤采用经外踝钢板双螺钉交接棒技术内固定治疗。疗效采用美国足踝外科协会踝与后足功能评分（AOFAS）评定。结果 33例术后均获得平均23.6（12~38）个月随访。术后摄X线片检查示平均13（9~15）周骨折愈合。2例开放性损伤患者伤口均一期缝合,无感染发生。随访过程中未出现内固定断裂及复位丢失,无骨不连、畸形愈合及踝关节不稳。末次随访时采用AOFAS踝与后足功能评分评定疗效：平均84.7（43~95）分;优12例,良18例,可2例,差1例,优良率90.9%。结论经外踝钢板双螺钉交接棒技术可以结合2种螺钉的固定优势,具有创伤小、操作简便、固定可靠有效的优点,是治疗下胫腓联合损伤的较好方法。

Objective To explore the clinical effects of double screw exchange-baton technique through the lateral malleolar plate in treating distal tibiofibular syndesmosis injury. Methods From January 2009 to June 2012, 33 patients with distal tibiofibular syndesmosis injury were treated by double screw exchange-baton technique. The functional outcomes was evaluated by the Ankle-Hindfoot scale system of American Orthopaedic Foot and Ankle Society （AOFAS）. Results All of 33 cases were followed up, with a mean duration of 23.6 months（12 to 38 months）. Bone healing was achieved on the radiographs 9-15 weeks （average 13 weeks） after operation. There were no infection,implant failure,non-union and instability of ankle. The mean AOFAS scale was 84.7 （43-95）points. There were excellent in 12 cases, good in 18,fair in 2,and poor in 1 case. The excellent and good rate was 90.9%. Conclusion In treatment of distal tibiofibular syndesmosis injury, double screw exchange-baton technique through the lateral malleolar plate is a reliable technique because it can be combined with two kinds of screw fixation, with minimal invasion, easily and efficiently.