踝关节严重外旋型损伤的手术治疗

目的探讨踝关节严重外旋型损伤的手术方法及临床疗效。方法2003年3月至2007年2月采用一期骨折切开复位治疗76例踝关节严重外旋型损伤患者，其中男48例，女28例，平均年龄39．6岁（17-69岁）。左侧43例，右侧33例。所有病例均有内外踝骨折。腓骨外踝骨折均行腓骨解剖复位1／3圆管形钢板内固定，下胫腓联合、后踝、内踝复位后用加压空心螺纹钉固定。术后石膏托固定4～6周。结果术后平均随访18．2个月，根据Meyer和Kumler踝关节功能评估标准，对术后疗效进行评价，76例中优42例，良21例，一般11例，差2例。优良率为82．9％。结论切开复位内固定治疗踝关节严重外旋型损伤具有良好的疗效，可最大限度地恢复踝关节的功能。

Surgical Treatment for Severe Eexternal Rotation Ankle Injury

Objective To study the technique and effect of the therapy for severe external rotation ankle injury by operation. Methods From March 2003 to February 2007, 76 cases were treated with primary open restoration and internal fixation for severe external rotation ankle injury, with 48 male and 28 female, with an average age of 39.6 years （ranging from 17-69 years） including 43 cases with left ankle injury and 33cases with fight ankle injury. All the patients were treated with fibula open reducted anatomically and fixed by 1/3 tubular plate. The syndesmosis, posterior malleolar fracture and internal malleolar fracture were fixed by compression hollow screw after reduction. All the patients were treated by plaster external fixation for 4-6 weeks after operation. Results The patients were evaluated by the criteria of Meyer and Kumler, a mean follow-up of 18.2 months revealed that excellent results occurred in 41 injuries, good in 20, fair in 11, and poor in 2. The total excellent and good results were 63（82.9% ）. Conclusions Internal fixation operation for treating severe external rotation ankle injury is effective, which can maximize the restoration of the function of ankle joints.