三踝骨折手术治疗52例体会

目的:总结切开复位内固定治疗三踝骨折疗效。方法:采用前内侧孤形切口暴露内踝、后踝。腓骨后缘直切口暴露腓骨及外踝骨折,按照后踝、内踝、外踝和下胫腓联合顺序,行骨折复位及内固定。结果:随访12~36周后,根据美国足踝外科协会(AOFAS)制定的踝关节评分标准,52例中优30例,良17例,可5例,优良率90.4%,骨折愈合时间平均14周。结论:旋前外旋、旋后外旋三踝骨折通过切开复位、恢复踝关节的解剖关系、骨折的可靠固定,可有效恢复踝关节功能。

The experience of surgical treatment for trimalleolar fracture in 52 cases

Objective： To summarize the technique and effect of the open reduction and internal fixation surgical operation for trimalleolar fractures. Methods：The arc-shaped inside incision was done to expose the medial malleolus and posterior malleolus. Through a straight incision in trailing edge of fibula, fractures of fibula and lateral malleolus were showed in surgery vision. Then fracture restoration and internal fixation were carried out by the sequence of posterior malleolus, medial malleolus, lateral malleolus and distal tibiofibular syndesmosis. Results：According to the criterion of AOFAS,30 patients were classified in excellent, 17 in good,5 in fair. The total percentage of excellent or good effects in all of 52 cases were 90.4% after a follow-up period of 12 - 36 weeks. Fractures were healed up in average 14 weeks. Conclusions：For these patients with pronation and supination external rotation trimalleolar fractures, the ankles function of fractures could have effective recovered through open restoration ,steady fixation and restoring the anatomy relations of the ankle joints.