胫腓下关节分离的手术治疗(附92例报告)

作者报告手术治疗胫腓下关节分离92例,除固定内、外、后踝骨折及修补三角韧带外,均常规用长螺丝钉或骨栓固定胫腓下联合.随访6个月～5年,优59例(64.1%),良26例(28.3%),可5例(5.4%),差2例(2.2%),优良率92%.结果表明,损伤后应力下摄X线片,可避免胫腓下关节分离的漏诊;固定时保持踝关节于中立位,应注意螺丝钉的松紧度及外踝正常的向外15°倾角,以维持踝穴的正常宽度;对陈旧性损伤,复位前彻底清除关节内疤痕,有利于胫腓下关节的复位及踝关节功能的恢复.

The Operative Treatment of Separation of the Tibiofibular Joint(A Peport of 92 Cases)

The authors reported 92 cases with separation of the tibiofibular joint treated in hospital. In addition to open reduction and internal fixation of the fractures of the medial and lateral mallolus and the posterior tibialmargin and repairment of the triquetral ligament of the foot. The separated of the tibiofibular joint was fixed with a long screw or a bolt to keep the stable of the ankle mortise and faciliate the repairment of injured ligament. 92 cases were followed-up from 6 months to 5 years. 59cases were excellent(64.1%),26 cases were good(28. 3%),5 cases were improve(5. 4%) and 2 cases were poor(2. 2%). The total responsive rate were 92%. The findings demonstrated that the mis-diagnosis could be avoided when the injured joint was examined by X-ray in stress situation. The reduction with the ankle in neutral position and with the adequate tightness of the screw or bolt and put the lateral mallolus outside at a angle of 15?could maintain the normal wideth of the ankle mortise. To make the reduction easy and recover the function of injured joint, the scars in the joint must be removed before reduction.