骨折间隙直视下复位固定后踝移位骨折

Reduction and internal fixation under direct vision through fracture gap for posterior malleolar displaced fracture

[目的]介绍骨折断端间隙直视法下三踝骨折中后踝移位骨折复位固定的手术技术与临床效果。[方法]选择2014年1月~2017年12月手足外科收治的三踝骨折中后踝移位骨折患者42例,采用骨折断端间隙直视法复位固定后踝骨折,采用骨骼肌肉功能评分(SMFA)评定患者术后恢复情况。[结果]所有患者均达到骨性愈合,术后未出现需要进行翻修手术或感染的病例,踝关节背伸跖屈功能良好。患者骨骼肌肉功能评分(SMFA)功能障碍指数平均为(8.01±1.73)分,SMFA困扰指数平均为(2.22±1.31)分。所有患者术后平均3个月进行正常的日常生活活动。[结论]对于三踝骨折中后踝移位骨折的治疗,采用后外侧入路骨折断端直视下复位固定方法可能是一种更好的选择。

[Objective]To introduce the surgical technique and clinical outcomes of open reduction and internal fixation(ORIF)under direct vision through the fracture gap for posterior malleolar displaced fracture in trimalleolar fractures.[Meth⁃ods]A total of 42 patients received ORIF for trimalleolar fractures accompanied with posterior malleolar displaced fractures from January 2014 to December 2017.The ORIF was conducted under direct vision through the gap of lateral malleolar frac⁃tures.The Short Musculoskeletal Function Assessment(SMFA)was used to evaluate the clinical outcomes.[Results]All pa⁃tients achieved bone healing,without revision surgery or infection after operation in anyone of them.The ankle joint flexion and flexion function recovered satisfactorily.All patients returned to normal daily activities in an average of 3 months after surgery,with SMFA dysfunction index of(8.01±1.73)and the SMFA trouble index of(2.22±1.31).[Conclusion]For posterior malleolar displaced fractures in the trimalleolar fracture,it may be a better choice to use this ORIF technique through the fracture gap under direct vision.