后内侧解剖板治疗陈旧后踝骨折伴踝关节脱位

目的探讨胫骨远端后内侧解剖板治疗陈旧性后踝骨折伴踝关节后脱位的临床疗效。方法采用小腿后内侧入路胫骨远端后内侧解剖型钢板内固定，对16例陈旧性后踝骨折伴踝关节后脱位患者进行手术治疗。结果术后随访8～24个月（平均12个月），所有伤口均一期愈合，无皮肤坏死、伤口感染、钢板外露等严重并发症。骨折临床愈合时间10～16周，平均12周。按Mazur踝关节功能评定标准进行评价，本组优12例，良3例，可1例，优良率93．75％。结论胫骨远端内后侧解剖型板符合胫骨远端内后侧的解剖形态，起到一种压板效应，能使陈旧后踝骨折块容易复位，固定确切可靠，符合后踝骨折固定的生物力学原理，对于陈旧后踝骨折伴踩关节后脱位具有明显的优越性。

Treatment of the Old Posterior Malleolus Fracture with Posterior Dislocation by Posteromedial Anatomy Plate of Distal Tibia

Objective To observe the clinical effect of treatment of the old posterior malleolus fracture with posterior dislocation by posteromedial anatomy plate of distal tibia. Methods Sixteen patients were treated with posteromedial anatomy plate of distal tibia by posteromedial approach. Results All cases were followed for 8 - 12 months ,The mean follow up was 10 monthcs. All wounds were primary healing and all fractures obtained bone-union. The mean healing time was 12 months. The Mazur score system of ankle showed 13 patients were excellent,4 good, and 1 fair. There were no severe complication. Conclusion Posteromedial anatomy plate of distal tibia fit for the anatomy of distal tibia and it has impaction plate effect so that the old posterior malleolus fracture easy to reruction and fix rigid. Treating the old posterior malleolus fracture with posterior dislocation with posteromedial anatomyplate of distal tibia suit for the biomechanics of posterior malleolus fracture and it has evidence advantage.