分类应用螺钉固定下胫腓联合在踝部骨折中的应用

目的:探讨分类应用螺钉固定下胫腓联合分离的手术方式及其在治疗踝关节骨折中的作用。方法:2001-2003年间收治踝部骨折伴下胫腓联合损伤110例,男46例,女64例;年龄18～70岁,平均40岁。按AODanisWeber分型:B型85例,C型25例。采用拉力螺钉固定95例,位置螺钉固定15例。结果:110例均得到随访,随访时间1.5～3年。根据踝关节症状与功能评分的Mazur标准,本组优60例,良38例,可12例,差0例,优良率达90%。无一例断钉。结论:分类应用拉力螺钉或位置螺钉固定下胫腓联合,是一种更科学的手术方法,临床疗效满意。

Fixation of distal tibiofibular junctures separation with different screws in the treatment of ankle joint fractures

Objective:To study the operative methods for the distal tibiofibular junctures separation with different screw,and to explore its application to the treatment of fractures of ankme joint.Methods:From 2001 to 2003,110 patients with fractures of ankle joint combined with distal tibiofibular syndesmotic disruption were treated with screws.Among them,46 patients were male and 64 patients were female,ranging in age from 18 to 70 years(mean 40 years).According to AO Danis-Weber classification,85 patients were Type B and 25 patients were Type C.Tension screws were applied to 95 patients and position screws used to 15 patients.Results:All the patients were followed up from 1.5 to 3 years.According to symptom and function score of Mazur criteria,60 patients obtained excellent results,38 good,12 fair and no bad.The excellent and good rate was 90%.No screw breakage occurred.Conclusion:Using tension screw or position screw to fix inferior tibifibular junctures separation is a good method of operation,and can reach satisfactory therapeutic effects.