不稳定性踝部骨折的手术治疗分析

目的 分析100 例不稳定性踝部骨折的手术治疗方法和疗效.方法 选取2010年8月至2012年11月,对100 例成人不稳定性踝关节骨折切开复位内固定手术组患者进行随访分析.本组入选病例中排除踝部开放性骨折和Pilon骨折.其中男49 例,女51 例;年龄18～81 岁,平均50 岁.按Danis-Weber分型,A型7 例,B型58 例,C型35 例.按Lauge-Hansen分型,旋前-外旋型21 例（Ⅲ度7 例,Ⅳ度14 例）,旋前-外展型Ⅲ度8 例,旋后-外旋型64 例（Ⅲ度9 例,Ⅳ度55 例）,旋后-内收型Ⅱ度7 例.根据美国矫形足踝协会踝与后足评分标准进行功能和疗效评估.结果 随访时间4～26个月,平均14个月,骨折愈合时间12～16周,平均为12.6周.本组评分68～100分,平均88.6分;优（90～100分）37 例,良（80～89分）49 例,一般（70～79分）13 例,小于等于69分为差1 例,优良率为86%.结论 正确手术方案制定和操作是不稳定性踝关节骨折外科手术治疗成功的关键.

Open Reduction and Internal Fixation in Treatment of Unstable Ankle Fracture

Objective To evaluate the chnical effectiveness of open reduction and internal fixation in the treatment of un- stable ankle fracture. Methods 100 patients with unstable ankle fracture who underwent open reduction and internal fixation between August 2010 and November 2010 were included and followed-up. Open ankle fracture and Pilon fracture were exclu- ded. Out of the 100,49 were male and 5 were female. Age ranged from 18 to 81 years,with an average age of 50. According to Danis -Weber,there were 7 cases of type A ,58 cases of B type and 35 cases of type C. According to Lange-Hansen classifica- tion system,2 cases were pronation-external rotation （ III ~7 cases, IV~ 14 cases） , 8 were pronation-abduction m o ,64 were su- pination-external rotation （III o 9 cases, IV ~ 55 cases） ,and 7 were supination-adduction II o. Function was assessed based on the American orthopaedic foot and ankle society （AOFAS） ankle and foot scoring criteria. Results The mean follow-up time was 1 4 months with a range of 4 to 2 6 months The recovery time of fracture varied from 1 2 to 1 6 weeks , with an average of 12.6 weeks. The average function and effectiveness score was 88.6 with 37 graded as optimal（90 - 90） ,49 good （80 - 89）, 13 mediocre （70 - 79 ）, and 1 poor 86% of patients reached good functional recovery. Conclusion Correct surgical procedure and operation is the key to a successful treatment of unstable ankle fracture.