骨折术后下胫腓骨骨性连接形成因素的相关性研究

Clinical study for the formation of distal tibiofibular synostosis following operative treatment on fractures

目的 探讨骨折术后下胫腓骨骨性连接形成因素.方法 回顾研究2010年9月至2014年9月的之间手术治疗28例胫腓远端骨折和29例踝部骨折临床资料,其中男39例,女18例;年龄8-71岁,平均年龄28.3岁,其中有8例出现下胫腓骨骨性连接,并对这8例患者的相关资料进行收集整理和分析.结果 8例下胫腓骨骨性连接患者中,有3例患者骨性连接发生骨折周围螺钉穿透过长部位,5例发生在胫腓骨骨折间且骨块未复位部位,无一例发生在下胫腓骨螺钉固定处,并对8例患者进行18-43个月随访,平均37个月,根据Mazur踝关节评分系统：优3例,良3例,可2例.结论 高能量损伤导致下胫腓骨骨折或踝部骨折,若骨折周围螺钉穿透过长、骨折处胫腓之间骨块未复位,是术后下胫腓骨骨性连接形成因素.

Objective To study formation of distal tibiofibular synostosis following operative treatment on fractures. Methods From September 2010 to September 2014, clinical database collected from 28 patients of distal tibiofibular fractures and 29 patients of ankle fractures underwent operation were evaluated. Distal tibiofibular synostosis occurred postoperation in 8 patients, related material and database of these 8 patients were collected and analyzed systematically. Results Formation of postoperative distal tibiofibnlar synostosis located on place of penetration of long screw head around fracture in 3 patients, while the other 5 patients located on site of distal tibiofibular fracture without reduction of small bone, none were found on the place of syndesmotic screw fixation. All of 8 cases were followed-up for 18 months to 43months, with an aver＇age of 37months, According to Mazur＇s ankle evaluation system, 3 patients achieved an excellent result,3 a good result and 2 a fair result. Conclusion Penetration of long screw head and without reduction of small bone around site of distal tibiofibular fracture caused by high energy were significant factors in the formation of postoperative distal tibiofibular synostosis.