踝关节骨折脱位与下胫腓联合分离的手术治疗(附65例报告)

作者对65例踝关节骨折脱位与下胫腓联合分离的患者进行了手术治疗.对外踝骨折伴有下胫腓联合分离者至少行4孔或6孔普通钢板固定,下胫腓联合行长螺钉固定.随访60例,随访时间4个月～4年8个月,优47例,良9例,可4例.认为按照Lauge-Hansen分类标准进行分类,可阐明受伤机制,指导临床做出正确的治疗方案.恢复外踝长度和稳定下胫腓关节,对踝关节的稳定和防止发生创伤性关节炎具有重要的意义.术中应注意固定下胫腓关节的松紧度,以防止踝关节背伸受限.

The Operative Treatment of Ankle Joint Fracture and Dislocation with Separation of the Syndesmosis Tibiofibularis (A Report of 65 cases)

Sixty-five cases of the ankle joint fractures and dislocations accompanied with separation of the syndesmosis tibiofibularis had been operated. The fractures of lateral malleoli accompanied with separation of the syndesmosis tibiofibularis had been fixed with 4 or 6 holes ordinary joint-bone plate (Scherman Plate),the syndesmosis tibiofibularis had been fixed with a longer screw. Sixty cases had been followed up from 4 months to 4. 8 years. There were excellent results in 47 cases,good results in 9 cases and poor results in 4 cases. The mechanism of injury could be instructed according to Lauge-Hansen's classification and draw up correct plan for the treatment. In order to keep the stability of the injured ankle joint and avoid traumatic arthritis. It is the important to restore the anatomical lateral malleoli and to fix the separated syndesmosis tibiofibularis. Moreover,to prevent the limitation of dorsal flexion of the ankle,the separation of the syndesmosis tibiofibularis must be screwed appropriately.