踝关节骨折伴下胫腓联合分离的手术治疗

摘要

Objective To summarize the outcomes of surgical treatment of ankle fracture with syndesmosis diastasis.Methods The open reduction and internal fixation and syndesmotic stabilization with a three cortices syndesmotic screw were performed in 40 patients of ankle fracture with syndesmosis diastasis.The syndesmotic screws were removed in 6～8 weeks after operation.All patients were followed up for 13 to 24 months and the clinical efficacy was evaluated using BairdJackson scoring.Results The excellent results were obtained in 22 cases, good in 10 cases, fair in 5 cases and poor in 3 cases with a total excellence rate of 80.0 ％.Five cases had radiological and clinical manifestations of steoarthritis and one case with breakage of syndesmotic screw.Conclusion The treatment of syndesmosis diastasis with corticescrew fixation in ankle fractures is effective.Good functional restolation can be obtained with anatomical reduction and stabilization of the tibiofibular syndesmosis.%目的 探讨踝关节骨折伴下胫腓联合分离的手术疗效.方法 选择踝关节骨折合并下胫腓联合分离患者40例.均行切开复位内固定加下胫腓螺钉固定,术后6～8周拆除下胫腓螺钉.结果 患者均获随访20个月.Baird-Jackson评分:优22例,良10例,可5例,差3例;优良率为80.0%.发生踝关节创伤性骨性关节炎5例,断钉1例.结论 手术治疗踝关节骨折伴下胫腓联合分离疗效肯定;精确修复并稳定下胫腓联合是手术成功的关键.