后侧腓骨钢板内固定在踝关节骨折中的应用

目的：探讨踝关节骨折治疗的新方法并评价其疗效。方法：手术治疗踝关节骨折42例,对其中资料完整的34例进行分析,男19例,女15例。根据Weber-AO分类：B型28例,C型6例。应用Baird和Jackson评分系统对其术后疗效进行评定,并将骨折类型、骨折固定方法、术后功能锻炼时间与最终功能的关系进行分析。对34例Weber-AO分型的B型及C型踝关节骨折,采用腓骨后侧钢板内固定,以避免螺钉对关节面的损伤,对同时伴有后踝骨折的病例,同时一个切口对腓骨及后踝进行固定。结果：随访时间1.2～3.2年,平均1.8年。34例中疗效为优24例,良6例,可4例,优良率为88.2%。结论：腓骨后侧钢板内固定治疗踝关节骨折,避免了螺钉对关节面的损伤,增加了螺钉的把持力,并可一个切口同时完成外踝及后踝骨折的治疗,为踝关节骨折治疗提供了一个新方法。

Application of the internal fixation of posterior fibula plate for the treatment of ankle fractures

Objective: To explore a new method for the treatment of ankle joint fractures,and to evaluate its therapeutic effects. Methods: Among 42 patients with ankle joint fractures,34 patients had complete data for analysis,19 patients were male and 15 patients were female,ranging in age from 21 to 61 years,with an average of 37 years. According to Weber-AO classification, there are 28 patients of B-type and 6 patients of C-type. The Baird and Jackson Rating System was used to evaluate therapeutic effects, and the relationship between the final function and fracture type,fracture fixation and,the time of functional training after operation were analyzed. Thirty-four patients with ankle joint fractures of B and C type were treated with internal fixation of posterior fibula plate to avoid injury of articular facet by the nails. The patients combined with the fractures of posterior malleolus were treated with fixation of both fibula and posterior malleolus through the same incision. Results: All the patients were followed up ranging from 1.2 to 3.2 years, with an average of 1.8 years. According to evaluation criterion,24 patients got an excellent result,6 good and 4 fair,the excellent and good rate was 88.2%. Conclusion: The internal fixation of posterior fibula plate,as a treatment for ankle joint fractures,successfully avoids the injury of articular facet by the nails. Not only does it enhance the pullout strength of the nails,but it is able to treat the fracture of lateral malleolus and posterior malleolus with a single incision. It has provided a new way for the treatment of ankle fractures.