PDLLA可吸收螺钉治疗踝关节骨折的临床研究

目的 探讨使用可吸收螺钉治疗踝关节骨折的适应证和经验教训。方法 使用超高分子聚-DL-乳酸(PDLLA)制成的自膨胀可吸收螺钉治疗踝关节骨折58例。切开复位后1—4枚螺钉固定，术中检查稳定性是否良好；术后定期随访，检查踝关节功能和X线检查。结果随访54例147枚螺钉。全部骨折无移位，均愈合良好，无细菌感染。患术后平均随访16月(3—28月)，根据国内王栋梁等综合功能评估标准，优良率达96.3％。结论 PDLLA自膨胀可吸收螺钉治疗踝关节骨折，操作简单，效果理想。只要手术时机恰当，术中精细操作，术中术后处理得当，并发症也是可以预防的。

Clinical study on treatment of fracture of ankle joint with PDLLA absorbable screw

Objective To discuss the indication and technique in treatin g fractures of ankle joint with controlled absorbable PDLLA screw. Methods 58 p atients with fracture of ankle joint were treated with open reduction and intern al fixation with 147 absorbable screws. After reduction, the fractures were fixe d with 1 to 4 PDLLA screws. The stability of the fracture fixation was checked. The patients were followed up for 3 to 28 months (mean, 16 months). They also ha d regular X ray checks and evaluations of the function of ankle joint. Results O ne screw was twisted off at the neck because of the faulty operation. According to the criteria set by Wang Dong-liang, the results of treatment were evaluated as excellent in 42 patients and good in 10 patients. The excellent and good rat e was 96.3%. No nonunion and no infection occurred. There were two patients who had sterile inflammatory reaction. Conclusion Treatment of ankle joint with abs orbable PDLLA screws is an effective method, and complications can be avoided wi th proper postoperative management.