外踝内固定器的临床初步应用研究

目的：通过临床试验研究，论证外踝内固定器治疗外踝骨折的可行性及实用性。方法：病例30例均为闭合性骨折，随机分甲、乙两组，每组15例，分别选择外踝内固定器、重建钢板固定。术前对所有患者踝关节功能Baird-Jackson标准评分；术后复查记录X线片、内固定拆除时间、踝关节功能等。结果：30例患者术后9～20月随访，平均13．4±2．8月。甲组无术口感染、钢板松动或折断等并发症；乙组2例术口感染致乙级愈合，1例术后钢板螺钉松动借助石膏外固定3月最终骨折愈合，遗留踝关节疼痛。两组骨痂生长定量指标、内固定拆除时间及术后踝关节功能评分等均有统计学意义（P〈O．05）。结论：外踝内固定器系统适用于成人外踝WeberB和部分Weber C、WeberA骨折患者，对外踝特殊类型骨折如粉碎性骨折、骨质疏松患者更为适用；对骨折行三维立体环抱式固定，术后骨折愈合快，患肢功能恢复优良，临床应用取得满意效果。

Preliminary research of clinical application of lateral malleolar internal fixator

Objective： To reserch the feasibility and practicability of internal fixator in treating lateral malleolar fracture. Methods： 30 cases were admitted from July 2007 to November 2010, 19 men, 11 women, 19 to 60 years old. All fractures were closed. According to Danis-Weber＇s classification： Weber I3 18 cases, Weber C 8 cases and Weber A 4 cases. The time from getting injured to accepting opertion was 4 to 20 days. They were randomly divided into 2 groups, 15 cases each; lateral malleolar internal fixator （LMIF） and reconstruction plate （RP） were applied to fix the lateral malleolar fracture respectively. The ankle function was evaluated by Baird- Jackson＇s standard before operation. The X-ray score, the time of taking down interal fixation and the score of ankle function were recorded after operation. Results： 30 cases were followed-up for 9 to 20 months. No infection or interal fixation failure occurred in LMIF group. In RP group, two cases had incision infection causing delayed union, one case had interal fixation failure which was fixed by piaster slab and healed three months later, but the ankle ache remained. The quantitative index of osteotylus, the time of dismantling interal fixation and the score of ankle function postoperation had significant differences between the two groups. Conclusion： LMIF is suitable to all kinds of lateral malleolar fracture, especially to Weber B and comminuted or osteoporosis fracture. The internal fixator can embrace bone fragments by three-dimensional fixation, facilitate the fracture regrowth and recover the function of the suffered limb.