旋后外旋型Ⅳ度踝关节骨折合并三角韧带断裂的手术治疗.docVIP

旋后外旋型Ⅳ度踝关节骨折合并三角韧带断裂的手术治疗 　　摘 要：目的 探讨旋后外旋型Ⅳ度踝关节骨折合并三角韧带断裂的手术治疗和临床疗效分析。方法 对36 例三角韧带完全断裂的旋后外旋型Ⅳ度踝关节骨折患者在骨折切开复位内固定的同时修复三角韧带。采用美国足踝外科学会（American orthopaedic foot and ankle society，AOFAS）踝-后足评分和视觉模拟评分系统（visual analoguescale，VAS）对手术效果进行评估分析。结果 36例患者术后获12 y以上随访，骨折均在4 y内愈合。末次随访时AOFAS踝-后足评分为84～97 分（平均95. 4 分），VAS 评分为0～4分，平均1.2分，无踝关节不稳定表现。结论 旋后外旋性Ⅳ度踝关节骨折合并三角韧带断裂患者，在切开复位内固定的同时根据断裂部位选择适当方法修补三角韧带，可以取得良好的手术效果。 　　关键词：踝关节骨折；切开复位；内固定；三角韧带 　　中图分类号：R687.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.01.074 　　文章编号：1006-1959（2018）01-0184-03 　　Surgical Treatment of Ⅳ Degree Ankle Joint Fracture Combined with the Rupture of the Ligamentum 　　BAI Jian-zhong，KUANG He-xia，XIONG Li，ZHANG Xiang-yang 　　（Department of Orthopedics，Tongren Hospital，School of Medicine，Shanghai Jiaotong University，Shanghai 200336，China） 　　Abstract：Objective To investigate the surgical treatment and clinical curative effect of Ⅳ degree ankle joint fracture combined with triangular ligament rupture.Methods The triangulation ligaments were repaired at the same time in 36 cases with complete fracture of the ligamentous ligaments of the posterior lateral rotation type IV ankle fracture.The American Orthopaedic Foot and Ankle Society（American orthopaedic foot and ankle society，AOFAS）ankle hindfoot score and visual analogue scoring system（visual，analoguescale，VAS）were the evaluation of the effect of surgery.Results 36 patients were followed for more than 12 months of follow-up，healing of fracture in 4 months.At the end of the follow-up AOFAS ankle hindfoot score of 84～97 points（average 95.4 points），VAS score of 0～4 points，an average of 1.2 points，no ankle instability.Conclusion Patients with deltoid ligament rupture supination of IV ankle fracture，with open reduction and internal fixation according to fracture site to choose the appropriate method for repairing the deltoid ligament，can achieve a good outcome. 　　Key words：Fracture of the ankle；Open reduction；Internal fixation；Trigonometric ligament 　　踝关节骨折（ankle frac