创伤性上胫腓关节脱位

目的:探讨创伤性上胫腓关节脱位的特点、诊断及治疗。方法:自2000年4月至2010年8月收治的创伤性急性上胫腓关节脱位12例,其中男10例,女2例;年龄18～60岁,平均30.6岁。根据Ogden分型:前外侧脱位8例,后内侧脱位2例,向上脱位2例。患者均表现为膝外下方肿胀,腓骨小头突出,腓骨小头疼痛,按压腓骨小头有浮动感。1例保守治疗,11例手术治疗。结果:12例均获随访,时间10个月～3年,平均18个月。按Lysholm评价标准:跛行(4.92±0.28)分,支撑(4.92±0.28)分,交锁(15.00±0.00)分,不稳定(24.58±0.79)分,疼痛(22.50±1.24)分,肿胀(8.50±0.90)分,爬楼梯(9.75±0.62)分,下蹲(4.92±0.28)分,总分(95.08±2.02)分;优11例,良1例。神经功能均恢复,X线检查无再脱位。结论:创伤性上胫腓关节脱位易漏诊,手术是主要的治疗方法,预后良好。

Traumatic dislocation of superior tibiofibular joint

Objective: To explore the characteristics,diagnosis and treatment on traumatic dislocation. Methods:From April 2000 to August 2010,12 patients with acute traumatic dislocation of superior tibiofibular joint were treated including 10 males and 2 females with an average age of 30.6 years old ranging from 18 to 60 years. According to Ogden classification,8 cases were the anterolateral dislocation,2 were posterior-medial dislocation,and 2 were upward dislocation. All patients had swelling in lateral-inferior of knee,fibular head prominent,fibular head pain,floating feeling in head of fibula. One case was treated by conservative treatment,and the remaining 11 cases by surgical treatment. Results:All patients were followed-up for 10 months to 3 years (means 18 months). Evaluation by Lysholm scoring,the total scores were 95.08±2.02,involving limbing 4.92±0.28,support 4.92±0.28,interlocking 15.00±0.00,instability 24.58±0.79,pain 22.50±1.24,swell 8.50±0.90,climbing stairs 9.75±0.62,squatting 4.92±0.28; 11 cases achieved excellent results and 1 good. Nerve functional recovered. X-ray was no longer dislocation. Conclusion:The diagnosis of traumatic dislocation is easy misseddiagnosis,surgery is the main treatment method,the prognosis is good.