旋前外旋型Ⅳ度踝关节骨折中固定与不固定腓骨骨折对下胫腓关节损伤疗效分析.docVIP

旋前外旋型Ⅳ度踝关节骨折中固定与不固定腓骨骨折对下胫腓关节损伤疗效分析 　　[摘要] 目的 观察旋前外旋型Ⅳ度踝关节骨折患者腓骨骨折的内固定与否对下胫腓关节损伤的意义。 方法 选择我院80例旋前外旋型Ⅳ度踝关节骨折患者为研究对象，分为观察组和对照组，在手术复位后观察组患者进行钢板内固定，对照组患者不加钢板。观察比较两组患者的术中出血量、愈合时间、AOFAS评分、疗效以及对下胫腓关节损伤的影响和并发症。 结果 观察组患者手术中出血量显著多于对照组（P0.05）。 结论 在旋前外旋型Ⅳ度踝关节骨折的患者中腓骨骨折内固定与否对下胫腓关节损伤的意义不大。 　　[关键词] 旋前外旋型；踝关节骨折；固定；下胫腓关节损伤 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2016）34-0058-03 　　The effect of fixed and non-fixed fibular fractures on lower tibiofibular joint injuries in pronation-external rotation type IV ankle fracture 　　DING Aijun ZHONG Wen 　　Yichun Second Peoples Hospital in Jiangxi Province， Yichun 336000， China 　　[Abstract] Objective To observe and compare the effect of internal fixed and non-fixed fibular fractures of fibular fracture on the injury of the tibiofibular joint in patients with pronation-external rotation type Ⅳ ankle fracture. Methods 80 patients with pronation-external rotation type Ⅳ ankle fracture were enrolled as study subjects and divided into observation group and control group. The patients in the observation group were treated with steel plate internal fixation after surgery reposition， while patients in the control group were not treated with steel plate. The intraoperative blood loss， healing time， AOFAS scores， curative effects on lower tibiofibular joint injury and complication were compared. Results The bleeding volume in the observation group was significantly more than that in the control group（P0.05）. Conclusion In patients with pronation-external rotation type Ⅳ ankle fracture， whether the fibular fracture was internally fixed or not is of little significance for the injury of the tibiofibular joint. 　　[Key words] Pronation-external rotation； Ankle fracture； Fixation； Lower tibiofibular joint injury 　　踝?P节是重要的负重关节，踝关节骨折主要是由于间接突然巨大的冲击力造成，如常见的内翻、外翻和外旋等[1]。Lauge-Hansen分类根据造成骨折的外力作用大小和方向以及受伤时的用力位置不同分为Ⅰ～Ⅳ度，能充分反映患者受伤时的足部姿势、暴力的方向及韧带的损伤等[2，3]。其中Ⅳ度损伤最为严重，一般伴随着下胫腓韧带复合体发生损伤，临床如果不及时恰当地处理，可能影响踝关节的运动功能，产生严重的功能障碍[4]。本研究旨在探讨旋前外旋型Ⅳ度踝关节骨折中固定与不固定腓骨骨折对