下胫腓分离的踝关节骨折合并三角韧带损伤的手术治疗体会

Experience of surgery for ankle joint fractures with lower tibiofibular separation complicated by triangular ligament injury

目的总结手术治疗下胫腓分离的踝关节骨折合并三角韧带损伤的体会。方法抽取2021年3月至2023年2月榆林市第一医院收治的100例下胫腓分离的踝关节骨折合并三角韧带损伤患者作为研究对象, 所有患者均接受手术治疗(外踝、后踝复位固定、下胫腓内固定以及三角韧带探查修复手术), 对患者的一般资料及手术情况等进行回顾性分析。结果 100例患者中踝关节恢复为优56例, 良38例, 中6例, 无恢复较差者, 优良率为94.00%(94/100)。与手术前相比, 手术后患者的美国足与踝关节协会评分系统评分上升, 视觉模拟评分法评分下降(P<0.05)。手术后, 患者踝关节内侧间隙为2.6~3.5(3.05±0.42)mm。手术后, 100例患者中仅1例出现感染情况, 并发症总发生率为1.00%(1/100)。结论下胫腓分离的踝关节骨折合并三角韧带损伤患者经手术治疗可获得良好的治疗效果, 术后疼痛与踝关节功能均能得到改善, 且并发症发生率低。

Objective To investigate the experience of surgery for ankle joint fractures with lower tibiofibular separation complicated by triangular ligament injury.Methods A total of 100 patients with ankle fractures with lower tibiofibular separation complicated by triangular ligament injury admitted to the First Hospital of Yulin from March 2021 to March 2023 were selected as the research subjects of this study.All subjects were treated by surgery(external ankle and posterior ankle reduction and fixation,lower tibiofibular internal fixation,and tibiofibular ligament exploration and repair surgery).The general information and surgical situation of selected patients were retrospectively analyzed.Results Among the 100 patients,56 cases had excellent ankle joint recovery,38 cases had good recovery,6 cases had medium recovery,but no poor recovery of ankle joint occurred;the excellent and good rate was 94.00%(94/100).Compared with preoperative scores,the American Association of Foot and Ankle Association score increased after operation,while the visual analogue scale score decreased(P<0.05).After surgery,the medial clear space was 2.6-3.5 mm,with an average of(3.05±0.42)mm.Among the 100 patients who underwent surgery,only 1 patient developed infection after operation,and the total incidence of complications was 1.00%(1/100).Conclusions Surgery therapy can achieve ideal outcomes in the treatment of ankle fractures with lower tibiofibular separation complicated by triangular ligament injury,improve postoperative pain and ankle joint function,with fewer complications.