旋前-外旋型Ⅲ度踝关节骨折的手术治疗

发布时间：2018-07-13 15:05

【摘要】：目的总结手术治疗旋前-外旋型Ⅲ度踝关节骨折的近期疗效。方法 2011年10月—2015年5月采用内固定结合下胫腓前韧带修复治疗旋前-外旋型Ⅲ度踝关节骨折36例。男21例,女15例;年龄21~72岁,平均45.2岁。致伤原因:扭伤19例,交通事故伤6例,高处坠落伤11例。均为闭合性骨折,无血管、神经损伤。左踝13例,右踝23例。伤后至手术时间3~10 d,平均6.5 d。末次随访时根据美国矫形足踝协会(AOFAS)踝-后足功能评分评定踝关节功能,采用疼痛视觉模拟评分(VAS)评价疼痛改善情况。结果术后患者切口均Ⅰ期愈合,无切口感染和皮肤坏死。28关节骨折均愈合,愈合时间为2.6~5个月,平均3.2个月。未发生内固定物断裂及下胫腓联合分离。末次随访时AOFAS疼痛评分(36.3±2.9)分,功能评分(44.3±3.2)分,韧带情况评分(9.2±0.5)分,总分(89.8±6.6)分;其中优11例,良15例,可2例。VAS评分为(1.6±0.5)分。踝关节活动度背伸(13±5)°,跖屈(38±9)°。结论在旋前-外旋型Ⅲ度踝关节骨折手术治疗中,下胫腓前韧带修复是治疗下胫腓联合损伤的有效方法,手术操作简便,近期疗效满意。
[Abstract]:Objective to summarize the recent curative effect of surgical treatment for the type III ankle fracture of pronation and external rotation. Methods from October 2011 to May 2015, internal fixation combined with anterior tibiofibular ligament repair in 36 cases, 21 males and 15 females, aged 21~72 years, with an average of 45.2 years old. The cause of injury was 19 cases of sprain, 6 cases of traffic accident injury. 11 cases of falling injury were closed fracture, no blood vessel, nerve injury, 13 cases of left ankle and 23 right ankle. After injury to operation time 3~10 D, the average ankle function of the American Orthopedic ankle Association (AOFAS) ankle posterior foot function score was assessed at the end of 6.5 D., and the pain improvement was evaluated by pain visual analogue score (VAS). Results after the operation All the wounds healed in stage I, without incision infection and skin necrosis.28 joint fracture healing, the healing time was 2.6~5 months, average 3.2 months. No internal fixation fracture and lower tibiofibular joint separation. At the last follow-up, AOFAS pain score (36.3 + 2.9), function score (44.3 + 3.2), ligament condition score (9.2 + 0.5), total score (89.8 + 6.6) There were 11 excellent cases, 15 good cases, 2 cases of.VAS score (1.6 + 0.5). The ankle joint activity was (13 + 5) degrees (13 + 5) and (38 + 9) degrees. Conclusion the repair of the anterior tibiofibular ligament was an effective method for the treatment of lower tibiofibular joint injury.
【作者单位】：杭州市萧山区中医院足踝外科;
【基金】：杭州市卫生计生科技计划项目(2015B24)~~
【分类号】：R687.4

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