三踝骨折及其手术治疗

从1986年5月～1996年1月收治三踝骨折24例,手法整复6例,余18例经开放整复内固定术治疗。采用螺丝钉固定内踝13例,外踝6例,后踝8例;外踝经克氏针固定5例,克氏针加钢丝固定1例。作者认为三踝骨折是复合性的踝关节骨折,应尽早手术,解剖复位和坚固内固定,才能保证踝关节功能恢复,防止创伤性关节炎发生。本文提出了先外踝,再后、内踝的整复次序,尽早整复固定下胫腓骨韧带联合分离,重视对外踝的正确处理。

Trimalleolar Fractures of the Ankle and Surgical Treatment

Twenty-four cases of tri-malleolar fractures of the ankle were treated from May 1986 to January 1996. Six cases were treatd by manual reduction,remain cases by open reduction and internal fixation. Thirteen medial,six lateral and eight posterior malleo-lar fractures were treated with internal fixation using screws,five lateral malleolar fractures using Kirschner wire one used of Kirschner wire and smaller caliber stainless wire,These patients were followed up in an average period of 3. 2 years. Authors believed that tri-malleolar fracture was the complicated fracture of the ankle. The damaged mechanism is that the ankle was affected by a strong enough and rotary force. Tri-malleolar fracture must be treated early with operation,anatomical reduction and rigid internal fixation to ensure normally functional recovery and prevent traumatic arthritis. This report discussed on the order of the reduction of tri-malleolar fractures .early fixation of the distal tibiofobular syndesmosis and exact managent of lateral malleolus.