手术治疗踝关节骨折常见诊治失误分析

目的回顾性分析踝关节骨折手术治疗中的常见失误及防治措施。方法2004年1月-2009年12月，192例踝关节骨折患者行手术治疗并获得随访，所有病例行切开复位内固定，术后早期进行功能锻炼。结果192例患者得到随访，随访时间12～36个月，平均25．6个月。所有骨折均愈合，临床愈合时间10～19周。术后踝关节功能评定依据Baird—JacksOn评分系统评定：优151例，良31例，可7例，差3例，优良率94．6％。结论对踝关节骨折进行详尽的术前评估，并据此制定个体化的手术方案，可以减少诊治失误，恢复踝关节的解剖复位及稳定，得到满意的治疗效果。

Analysis of common fault in diagnosis and treatment for ankle fractures

Objective To analyze of common failure in surgical treatment of ankle fracture and its prevention measures.Methods Since January 2004 to December 2009,192 cases of ankle fractures were treated with operation and followed up.The different methods of open reduction and internal fixation were separately used for different cases.Early postoperative functional exerciseswas was done to all cases.Results Follow-ups to all cases lasted for an average times of 25.6 months,ranging from 12 months to 36 months.The fractures of all cases united within 10-19 weeks.The rates of clinical result were exellent in 152,good in 31,fair in 7,poor in 3 respectively,with a 94.6% rate of good and exellent according to Baird-Jackson scores system.One patient presented with tibiofibular diastasis after 3 months.Conclusion Thorough preoperative evaluation of ankle fracture and thus develop individualized surgical plan can reduce errors in diagnosis and treatment,recovery of anatomic reduction and stability of the ankle,and be satisfied with the treatment.