一期修复三角韧带手术治疗踝关节旋后外旋Ⅳ型骨折的疗效分析.pdfVIP

骨科2015年第6卷第4期　 Orthopaedics,July2015,Vol. 6,Iss. 4 ·183 · ·临床研究论著 · 一期修复三角韧带手术治疗踝关节旋后外旋 Ⅳ型骨折的疗效分析 赵萌　 邹剑　 曹学伟 　 　 【摘要】　 目的　 探讨一期修复三角韧带手术治疗伴三角韧带撕裂的踝关节旋后外旋Ⅳ型骨折的 临床疗效。 方法　 自2011年1月至2013年2月,根据Lauge-Hansen分型,对19例伴三角韧带撕裂的踝 关节旋后外旋Ⅳ型骨折采用骨折切开复位钢板内固定,三角韧带铆钉修复的手术方法进行治疗。 末次 随访应用Mazur踝关节评分系统,根据愈后疼痛程度、功能及踝关节活动范围对治疗结果进行评估。 结 果　 所有患者均获得随访,术后平均随访时间17.3个月(14.0~25.0个月),骨折处均获得骨性愈合, 平均愈合时间4.7 个月(4.2 ~6.9 个月),踝穴正常,无创伤性关节炎。 Mazur 踝关节评分:优6例, 良11例,可2例,优良率为89.5%。 结论　 伴三角韧带撕裂的踝关节旋后外旋Ⅳ型骨折采用骨折切开 复位钢板内固定,三角韧带铆钉修复的手术方法,能够获得满意的临床疗效。 【关键词】　 三角韧带;骨折固定术,内;踝关节 Efficacy of one-stage repair of deltoid ligament for supination-external rotation type Ⅳankle frac- ∗ ∗ tures. ZHAOMeng ,ZOU Jian,CAO Xuewei. Department of Orthopaedics,the Central Hospital of Zibo Mining Group,Zibo255120,China 【Abstract】　 Objective　 Tostudytheefficacyofone-stagerepairofdeltoidligamentforsupination-exter- nal rotation type Ⅳ ankle fractures. Methods　 From Jan. 2011 to Feb. 2013,according to Lauge-Hansen classification,19 cases of supination-external rotation type Ⅳ ankle fractures with deltoid ligament disruption were treatedwithanchorrepairplusopenreductioninternalfixation. Functionandradiographicimageswerean- alyzed,and ankle range of motion was evaluated by Mazur criteria at the latest follow-up. Results　 All cases were followed-up for14.0to25.0 months (17.3 monthson average). Theaveragehealingtimeoffracturewas 4.7 months (4.2-6.9 months). Themortiseswerenormalandnotraumaticarthritisoccurred. Excellenteffica- cy was obtaine in6 cases,good in 11 cases and fair in 2 cases with the excellent-to-good rate being 89.5%. Conclusion　 Anchorrepairplusopen reductioninternalfixationintreatingsupination-externalrotationtype Ⅳ anklefractureswith deltoid ligament disruption can obtain satisfactory clinical efficacy. 【Key words】　 Deltoid ligament;Fracturefixa