踝关节骨折治疗进展方案.docxVIP

踝关节骨折治疗进展方案 踝关节骨折治疗进展方案 踝关节骨折治疗进展方案 踝关节骨折的治疗进展 王国利 李成才 纲要：踝关节骨折临床上较常有， 包含单踝骨折， 双踝 骨折，三踝骨折和腓骨骨折。骨折分型包含 Ashhurs 分型、 Danis-Weber 分 型 以 及 在 此 基 础上 提 出 的 AO 分 型 、 Lauge-Hansen 分型。踝关节骨折应重申停剖复位、坚毅固 定。可采纳非手术治疗和手术治疗。手术治疗的要点应恢复 踝穴正常解剖关系。应先固定腓骨，后固定后踝和内踝，最 后固定下胫腓。手术机遇能够在伤后 6—8h ，也可延至伤后 3-14d 。腓骨远端骨折的固定可采用单枚螺钉、克氏针张力 带、外侧中和（保护）钢板或后侧抗滑钢板。内踝、后踝的 内固定建议使用克氏钟张力带， 螺钉、空心钉或可汲取螺钉。 下胫腓的功能是防备距骨过分外旋、外展，对保持踝关节的 功能极为重要。 下胫腓结合损害能否固定应术中依据 Cotton 试验判断下胫腓结合的稳固性来决定。固定方法包含螺钉固 定、胫腓钩固定、钩板、钢丝捆扎带以及韧带重修等。 要点词：踝关节骨折；分型；内固定；下胫腓结合 Abstract: The ankle fractures clinical less common, including single ankle fractures, double ankle fractures, three ankle fractures and fibula fractures. Fracture classification including Ashhurs , Danis-Weber and AO based on Danis-Weber, Lauge-Hansen . Ankle fractures 作者单位： 300350 天津市津南区咸水沽医院骨科 should emphasize anatomical reattachment, strong fixed. Can take nonoperative treatment and surgery. The surgical treatment of key should be restored ankle acupuncture point the normal anatomy. Operation should be fixed first fibula and posterior malleolar and medial malleolar , finally fixed The lower tibiofibular ligament union. The operation time can hurt in 6-8 h, also can be extended to 3 to 14 d after injury. Fibular end fractures fixed can choose single pieces screw, Kirschner tension band , and lateral neutralization (protection) steel plate or Sliding resistance back plate. medial malleolar and posterior malleolar, fixation suggest using Kirschner tension band , screw, cannulated screws or can absorb the screws. The function of the lower tibiofibular ligament union is to prevent the talus excessive spin and outreach, to maintain the function of the ankle is very important. The lower tibiofibular ligament union damage whether fixed should intraoperative according to Cotton test judgment the stability of the lower tibiofibular ligament union will decide. Fixed methods including screws, tibial phil hooks, hook board, steel wire strapping belt and ligament reconstruction, etc. Keywo