踝关节骨折中外踝骨折手术方法及临床意义.docVIP

踝关节骨折中外踝骨折手术方法及临床意义【摘要】目的：探讨踝关节骨折中外踝骨折的手术方法和治疗效果、注意事项及临床意义。方法：回顾分析76例有移位的外踝骨折患者采用手术内固定治疗，应用改良的Baird和Jackson评分系统对疗效进行评定，将骨折类型、内固定方法、术后功能锻炼时间与关节功能的关系进行分析。结果：随访时间为3-16个月，平均12个月。76例疗效为：优56例，良18例，可2例，差0例，优良率97.3％。结论：手术治疗踝关节骨折可取得满意的骨折复位和临床疗效，判断骨折类型和正确选择固定方法对于提高外踝骨折复位内固定质量，改善远期疗效十分重要。 【关键词】踝关节骨折；外踝骨折； 手术治疗方法； 治疗结果 【中图分类号】R687.3 【文献标识码】A 【文章编号】1008-6455（2010）11-0008-02 The surgical treatment techniques and clinical significance of laternal malleolus fractures in ankle fractures Shen JuexinShi Baohua 【Abstract】Objective:To study the surgical techniques and effect、notices and clinical significance of open reduction and internal fixation for laternal malleolus fractures in ankle fractures．Methods seventy-six patients with laternal malleolus fractures were treated with open reduction and internal fixation from March 2005 to June 2010．A11 thepatients were evaluatedwith modified Baird and Jackson scoring system．The relationship among final result，fracture pattern，fixation methods and the time of exercise initiation after operationwere analyzed respectively．Results A11 the patients were followed up from 3 to 16 months(average 12 months)．In 76 patients，there were 56 cases with excellent result，18 cases with good result，2 cases with fair result，0 cases with poor result．The total rate of excellent and good results was 97.3％．Conclusions There was satisfactory effect of the surgical treatment on laternal malleolus fracture of ankle joint．The estimation of fracture pattern and proper selection of internal fixation were of important to achieve and improve reduction quality, and to ameliorate better long term results. 【Key words】ankle fracture；laternal malleolus fracture；fracture fixation；surgical technique 外踝骨折是骨科临床上的常见病，合理的治疗是关节功能得以最大恢复的保障。本院自2005年3月-2010年6月，共收治踝骨折包含有移位的外踝骨折患者76例，根据Danis-Weber分型[1]进行相应治疗，取得较满意疗效，报道如下。? 1临床资料 1.1一般资料:本组76例，男42例，女34例，年龄18～64岁，平均35岁。致伤原因：车祸伤25例，生活扭33例，坠落伤18例。其中双踝骨折31例，三踝骨折24例，单纯外踝骨折19例，单纯性外踝骨折合并第5跖骨基底骨折2例，开放骨折15例。合并内侧三角韧带损伤21例，合