后外侧联合内侧手术切口治疗三踝骨折的疗效分析.docVIP

后外侧联合内侧手术切口治疗三踝骨折的疗效分析 】目的：探讨后外侧联合内侧入路手术治疗 三踝骨折的临床疗效。方法：回顾性分析2006年5月-2012 年11月因三踝骨折来本院治疗者43例，手术均采用后外侧 联合内侧入路切开复位钢板螺钉内固定，骨折端均未植骨。 分析患者骨折愈合情况、内固定稳定性和美国足踝外科 A0FAS评分。结果：所有患者均获得随访，随访时间10?21 个月，平均15个月；所有患者均获得骨性愈合，愈合时间 11?18周，平均13周；术后1例患者出现皮肤愈合不良、1 例切口感染，保守治疗后好转，无内固定松动断裂等并发症; 踝关节功能A0FAS评分(92. 2±5. 4)分。结论：采用后外 侧联合内侧入路手术治疗三踝骨折，可以使踝关节尽量获得 解剖复位，有利于早期功能锻炼，避免后期创伤性关节炎。 关键词】三踝骨折；后外侧联合内侧入路手术 [Abstract] Objective： To evaluate the surgical treatment outcome of posterolateral approach to the fibula for trimalleolar fractures. Method： 43 patients suffered from the trimalleolar fracture were treated with internal fixation via posterolateral transmalleolar approach from May 2006 to Nov 2012， no bone graft was used to promote healing. All patients were assessed with the healing of fracture ， manifestations, and the American Orthopaedic Foot and Ankle Society score (AOFAS) . Result： The followup period varied from 10-21 months with an average of 15 months, all fractures had bone union, time to bone union varied from 11—18 weeks with an average of 13 weeks. There was one skin healing problem, and one facial infection, no malnunion, nonunion of the fractures or the deformity of the ankle. The American Orthopaedic Foot and Ankle Society score was (92. 2±5. 4 )， suggesting an excellent result. Conclusion： Posterolateral approach to the fibula for trimalleolar fractures allows direct reduction and instability ，walking ability instability ， walking ability ， radiological fixation of the bone fracture fragments ， ensure good for earlyanatomical joint restoration ， good for early functional exercise， and avoid the appearance of traumatic arthritis. Key words 】 Trimalleolar fractures ； Posterolateral transmalleolar approach First-author? s address： Zhongshan Banfu Hospital， Zhongshan 528459， China doi： 10. 3969/j. issn. 1674-4985. 2015.01. 049 踝关节是人体行走的枢纽，其稳定性及灵活性皆十分重 要［1-2］。三踝骨折直接影响踝关节正常解剖结构域稳定性， 是严重的踝关节骨折，其治疗不及时或不当将造成踝关节不 稳、创伤性关节炎，严重影响患者的生活及工作［3］。三踝 骨折的治疗要求早期解剖复位、坚强内固定，早期功能锻炼， 防止创伤性关节炎发生［4