下胫腓联合损伤的弹性固定治疗进展

Progress of Elastic Fixation for Distal Tibiofibular Syndesmosis Injury

下胫腓联合是维持踝关节稳定的重要结构,踝关节损伤常伴有下胫腓联合损伤,越来越多的骨科医师开始在治疗踝关节损伤时重视下胫腓联合的诊疗。随着生物学固定理念逐渐普及,既往作为治疗金标准的下胫腓联合螺钉固定技术因存在相关并发症而逐渐受到质疑。弹性固定符合下胫腓联合的解剖及生物力学特点,逐渐被认可并推广。目前,弹性固定的方法主要有韧带重建(自体和异体)、锚钉缝合重建、Endobutton系统、Suture button系统和胫腓钩等固定装置。各种方法均有各自的临床适应证及优缺点。

Syndesmosis of the distal tibiofibular is an important structure to maintain stable ankle,which is often damaged associated with the ankle joint injury.More and more orthopedic surgeons are paying attention to the diagnosis and treatment of distal tibiofibular syndesmosis during the operation of damaged ankle joint.With the growing popularity of the biological fixation concept,the strong screw internal fixation,as the past gold standard of treatment,is gradually questioned by clinicians due to its related complications.On the contrary,elastic fixation is gradually being adopted for the treatment of distal tibiofibular syndesmosis injury by more and more clinical orthopedic surgeons,because it conforms to the anatomy of the lower tibiofibular syndesmosis and the predominant biomechanical characteristics.Currently,there are many methods for elastic fixation,including ligaments reconstruction(autograft and allograft),anchor suture reconstruction,Endobutton system reconstruction,Suture button system reconstruction and tibiofibular hook fixation,each with own clinical indications and advantages and disadvantages.