骨折后腓骨长度的恢复与踝关节创伤性关节炎的关系

目的　探讨胫腓骨下段粉碎骨折后腓骨长度的恢复与踝关节创伤性关节炎发生的关系。方法　 1986～ 1996年间收治的胫腓骨双骨折病例中 ,有 15 0例获得随访的经过手术治疗的闭合性胫腓骨下段粉碎骨折。平均随访时间为 6年 (2～ 10年 )。15 0例中 30例在固定胫骨的同时固定腓骨 ,恢复腓骨长度 ,12 0例仅固定胫骨。术后均以石膏托固定 4～ 6周。结果　腓骨固定组术后踝关节不同程度创伤性关节炎的发生率为 6 % ,而单纯固定胫骨者 ,创伤性关节炎的发生率为 30 %。结论　踝关节创伤性炎症的发生与小腿双骨折后腓骨长度是否恢复有关 (r=0 0 0 98) ,在治疗胫腓骨下段骨折时应注意恢复腓骨的长度

Relationship Between the Recovery of the Length of Fibula and Traumatic Arthritis of Ankle Joint after Fracture

Objective To study relationship between the recovery of the length of fibula and traumatic arthritis of ankle joint after communicated fractures of distal part of tibia and fibula.Methods One hundred and fifty cases of fractures of distal part of tibia and fibula were treated and followed up in our hospital.The average follow-up time was 6 years(2 to 10 years).Fixation of both tibia and fibula was performed in 30 of 150 cases,and single tibia fixation was performed in 120 of 150 cases.All patients were immobilized with plaster after operation.Results The rate of the occurrence of traumatic arthritis of ankle joint in the group of fibula and tibia fixation was 6%,while in the group of single tibia fixation it was 30%.Conclusion The occurence of traumatic arthritis of ankle joint was related to the recovery of the length of fibula(r=0.0098).Therefore the length of fibula should be recovered in the treatment of communicated fractures of distal part of tibia and fibula