下胫腓联合损伤诊断与治疗的研究进展

Advanced progress of the diagnosis and treatment of inferior tibiofibular syndesmosis injury

下胫腓联合损伤为临床上常见的踝部损伤,多合并踝部其他损伤,较少单独发生,常发生在旋前—外旋和旋前—外展型踝关节骨折、脱位。结合病史、体格检查、影像学检查等可明确诊断。对于无骨折的单纯性下胫腓联合损伤,即下胫腓联合稳定,可采用保守治疗。对不稳定的下胫腓联合损伤需积极手术治疗,但选取何种内固定方法仍存在争议。本文回顾总结国内外近年来的文献,从下胫腓联合的解剖及生物力学、损伤的诊断与治疗等几方面进行了综述。

Inferior tibiofibular syndesmosis injury is a common ankle injury in clinic.Such impairment rarely occurs alone, rather they happen complicated with other ankle injuries.The disease occurs most frequently at ankle joint＇s fracture dislocation of type of pronation-external rotation and pronation-external abduction. Diagnosis can be made with careful physical examination combined with patient＇s history and the imaging examination. Patients with simple injury of the inferior tibiofibular syndesmosis with no fracture（inferior tibiofibular syndesmosis has stability） can be treated with conservative method. And the positive operation treatment should be taken, if the disease is of unstable type. However, there are still controversies for choosing internal fixation method for the treatment. This paper summarizes the anatomy and biomechanics of inferior tibiofibular syndesmosis along with diagnosis and treatment of the injury, according to review and summarized documents at home and abroad in recent years.