对一例下胫腓联合损伤三联征患者二次手术后的康复治疗体会 - 华西医学.pdf

• 12 • West China Medical Journal, Jan. 2017, Vol. 32, No.1 ·论 著· 对一例下胫腓联合损伤三联征患者 二次手术后的康复治疗体会 金晨，李婧 国家体育总局训练局体能康复中心（北京  100061 ） 【摘要】   目的    探讨下胫腓联合损伤三联征二次手术后的康复治疗方法。 方法    报告 1 例 16 岁男性患者 于 2014 年 2 月在运动训练时因右踝过度旋后造成右外踝关节骨折、下胫腓分离，于 2014 年 3 月在外院行外踝关 节镜探查，外踝骨折切开复位内固定。患者术后因过早负重造成内固定螺钉断裂，于 2014 年 8 月 20 日在外院行 内固定取出术。患者于 2014 年 9 月 25 日在国家体育总局训练局体能康复中心进行康复治疗，分析其康复评定结 果并调整康复治疗方案。 结果    康复第 1 阶段结束时患者右侧踝关节肌力、踝关节活动度、Y形平衡测试评定结 果均较左侧差；康复第 2 阶段末各指标测量结果与第 1 阶段末比较有明显好转；康复第 3 阶段末仅有右腿站立 下蹲前向稍差，右侧踝关节肌力、踝关节活动度及其余方向下蹲均接近正常。 结论    通过治疗-评估-改进治疗-再 评估的系统康复模式可应对复杂型踝关节运动损伤。 【关键词】  下胫腓联合；外踝骨折；三角韧带；内固定断裂；康复治疗 Experience of rehabilitation treatment for one patient with distal tibiofibular syndesmosis injury triad after the second surgery JIN Chen, LI Jing Rehabilitation Center of National Sports Training Center, Beijing 100061, P. R. China Corresponding author: LI Jing, Email: 376439479@ 【Abstract 】 Objective    To investigate the rehabilitation treatment methods for distal tibiofibular syndesmosis injury triad after the second surgery. Methods    We reported the postsurgical rehabilitation treatment for a 16-year-old male who received second surgery for internal fixation screw rupture on August 20th 2014, due to weight bearing too early after his first surgery in March 2014 for distal tibiofibular syndesmosis diastasis combined with lateral malleolus fracture, ligamenta talofibulare anterius and deltoid ligament rupture. The patient was treated in the Rehabilitation Center of National Sports Training Center on September 25th, 2014. By analyzing the rehabilitation assessment results, a secondary ankle impingement syndrome was detected and following modified treatments were implemented. Results    At the end of the first course of treatment, right ankle muscle strength, range of motion and Y balance tests were all weaker than the left. At the end of the second course