旋前、后外旋型踝关节骨折下胫腓联合治疗与康复

目的探讨分析如何提高对Ⅲ、Ⅳ度旋前、后外旋型踝关节骨折下胫腓联合治疗的手术疗效。方法回顾分析62例Ⅲ、Ⅳ度旋前、后外旋型踝关节骨折下胫腓联合损伤的手术及康复方法与随访效果。结果随访62例，时间2—6年，平均3．5年。疗效优良：46例（74．2％）、可：13例（21％）、差：3例（4．8％），优良率为73．8％。结论辅助早期功能锻炼是治疗Ⅲ、Ⅳ度旋前、后外旋型踝关节骨折的关键。

The treatment and rehabilitation of infra-tibiofibular joint in pronated and supinated and external rotation ankle fracture

Objective To report the long-term observation of treatment of infra-tibiofibular joint in pronated and supinated and external rotation ankle fracture.Methods A retrospective analysis of the long-term result and surgical methods used to treat 62 patients with infra-tibiofibular syndesmosis in pronated and supinated and external rotation ankle fracture.With the use of fluoroscopic machine,reducing and fixing the external malleolus at first,then fixing the infra-tibiofibular syndesmosis and fixing the internal malleolus at last.When the fracture area of post-malleolus is larger than one fourth of the articular surface,a screw should be used to fix the fracture.Results The followed up period varied from 2 years to 36 years,with an average of 3.5 years.The treatment effectiveness for patients were excellent(46),good(13),fair and poor(3),respectively.The total percentage of good to excellent clinical effects was 73.8%.Conclusion Early diagnosis,early operation,anatomic reduction,recovering stability of ankle joints,fixing the infra-tibiofibular syndesmosis and early exercising is the key to treat injury of infra-tibiofibular joint in pronated and supinated and external rotation ankle fracture.