三踝骨折的手术治疗

目的：探讨三踝骨折切开复位内固定的方法和治疗效果。方法：2003年1月-2008年1月,采用切开复位钢板螺钉内固定的方法治疗三踝骨折45例。其中男25例,女20例;年龄18-75岁,平均42.5岁。闭合性骨折38例,开放性骨折7例,合并下胫腓联合分离10例。结果：全部患者均获随访,随访时间6-24个月,平均12个月。术后未发生骨不连、畸形愈合、胫腓下联合处螺钉断裂等并发症。骨折愈合时间为12-18周。踝关节功能按O lerud与Mon lander评分系统进行评定,其中优34例,良6例,可3例,差2例,优良率88.9%。结论：切开复位钢板螺钉内固定手术治疗三踝骨折可提高复位质量、重建踝关节稳定性,对踝关节功能恢复,改善远期疗效具有重要意义。

Surgical treatment of trimalleolar fractures

Objective To explore the surgical techniques of open reduction and internal fixation for trimalleolar fractures and evaluate the corresponding clinical outcomes.Method From January 2003 to January 2008,45 patients with trimalleolar fractures were treated with open reduction and internal fixation(25 males and 20 females,the age ranged from 18 to 75 years,42.5 in average).Among all patients,included 7 cases of open fractures,10 cases were accompany with separation of distal tibiofibular syndesmosis.Results All the cases were followed up for 6 to 24 months,12 months in average.There were no malunion or nonunion of the fractures,no broken of the screw was happened.The function of ankle joint were evaluated according to Olerud-Monlander ankle joint scoring system,including 34 cases in excellent,6 cases in good,3 cases in fair and 2 cases in poor.The excellent and good rate was 88.9%.Conclusion Open reduction and internal fixation is facilitate to articular reduction and reconstruct the stability of ankle joint,which is important for gain better long-term results.