中国骨伤2012，Vol.25Issue(6)：493-496,4.DOI:10.3969/j.issn.1003-0034.2012.06.013
内外踝联合手术治疗严重踝关节骨折
Combined medial and lateral malleolus operative treatment for severe fracture of ankle
石蛟 1陈兆军 2刘殿梅 1李树东 1王虎 1吴俊德2
作者信息
- 1. 承德市围场满族蒙古族自治县医院骨科,河北承德068450
- 2. 北京中医药大学第三附属医院手足外科,北京100029
- 折叠
摘要
Abstract
Objective:To explore the clinical effects of combined medial and lateral malleolus in treating severe fracture of ankle. Methods: From May 2007 to January 2011,89 patients with ankle fracture who underment surgical treatment and had complete follow-up,the data were retrospectively analyzed. In this study,there were 66 males and 23 females with an average age of 30.9 years (ranged, 26 to 62 years). Cause of injury included road accidents in 52 cases, sprains from fall down in 17, construction injury in 16 and other injuries in 4. According to type of Denis-Weber, type A were in 13 cases, type B in 24, type C in 52. Operative technique was as follows. Chosen two-incision of combined medial and lateral malleolus, and reduced lateral malleolus fracture firstly,fixed it with 1/3 tubular armor plate or rebuilt-titanium plate. To chose one or two hollow screws according to the size of fracture block. If fracture of fibula was syntripsis, it can be multi-segmental fixed. If fracture line of posterior malleolus was no more than 1/3 articular surface of ankle or the bone displacement was not serious, it can be disregarded. And if the lesion level was over 1/3, or shift position more than 3 mm, it can be fixed with lag screw after reduction. Either front-to-back or back-to-front fixed direction was OK. At the third day after operation, the patients were instructed to exercise with affected limb,weight training after 6 weeks. Results:Eighty-nine patients were followed up from 6 to 24 months with an average of 16 months. Healing time of the fracture was 10 to 12 months. According to standard of the Baird-Jackson scoring system, 68 cases got excellent results, 18 good and 3 fair. Conclusion; Surgical treatment is quite effective for severe fracture of ankle. It should be chosen correctly according to types of the fracture and degree of ligament injury. At the same time, damage degree of the ligament around the ankle should be considered and properly treated.关键词
踝关节/骨折/骨折固定术,内/外科手术Key words
Ankle joints Fractures/Fracture fixation,internal/Surgical procedures,operative引用本文复制引用
石蛟,陈兆军,刘殿梅,李树东,王虎,吴俊德..内外踝联合手术治疗严重踝关节骨折[J].中国骨伤,2012,25(6):493-496,4.
