胫腓骨骨折术后屈拇屈趾畸形的治疗

目的探讨胫腓骨骨折术后并发屈拇屈趾畸形的病因及手术方法。方法2006年3月至2011年6月，我院共收治胫腓骨骨折术后屈拇屈趾畸形患者5例，胫骨均行闭合复位髓内钉内固定术，腓骨行切开复位钢板内固定术。患者于术后2～6个月出现不同程度足趾屈曲畸形，其中单纯拇趾屈曲畸形1例，拇趾伴有第二、三趾屈曲畸形4例，均采用肌腱粘连松解或延长术矫正畸形，距初次内固定术后时间为6～15个月。结果所有患者均获随访，随访时间8～18个月（平均12个月），所有拇趾足趾畸形均获矫正，未见复发，行走步态基本正常，无疼痛等不适。结论胫腓骨骨折术后屈拇屈趾畸形主要原因是肌腱与骨折处粘连以及肌肉缺血引起的纤维化，肌腱的松解和延长术是有效的治疗方法。

Treatment of flexion deformity of toes after fibular and tibia fracture surgery

Objective To investigate the causes and surgical treatment for flexion deformity of toes after fibular and tibia fracture surgery. Methods From March, 2006 to June, 2011, five patients with flexion deformity of the toes after fibular and tibia fracture surgery were admitted into our hospital; which were conducted closed reduction and intramedullary nail fixation for tibia fracture and open reduction and plate fixation for fibular fracture. The patients occurred different degrees of flexion deformity in the toe 2 to 6 months after the operation; among which, one case got simple toe flexion deformity and four cases the second and third toe flexion deformity; all were corrected by lysis of adhesions or tendon lengthening surgery. Results All patients were followed up average 12 months（8 to 18 months）; no case occurred postoperative complications.All the patients＇ toe deformities were corrected without relapse, pain, or any other discomforts. Conclusions The main causes of flexion deformity of toes after fibular and tibia fracture surgery is fibration, which were induced by muscle ischemia and tendon adhesion. Release and tendon lengthening are effective surgical treatment.