發(fā)布時間：2018-04-12 18:51

  本文選題：踝關節(jié)骨折 + 三角韌帶損傷��； 參考：《中國修復重建外科雜志》2015年04期

【摘要】：目的探討手術治療踝關節(jié)骨折伴三角韌帶損傷的療效。方法 2010年1月-2013年1月,收治11例踝關節(jié)骨折伴三角韌帶損傷患者。其中男7例,女4例;年齡18~72歲,平均38.2歲。受傷至手術時間為6 h~7 d,平均4 d。踝關節(jié)骨折根據(jù)Lauge-Hansen分型標準:旋前-外旋型5例,旋后-外旋型4例,旋前-外展型2例。踝關節(jié)彩色多普勒超聲及MRI檢查證實三角韌帶斷裂。麻醉后行外翻應力試驗、距骨外翻傾斜試驗和前抽屜試驗均為陽性。踝關節(jié)骨折行切開復位內(nèi)固定,探查并修復三角韌帶。結(jié)果術后切口均Ⅰ期愈合,無感染等手術相關并發(fā)癥發(fā)生�；颊呔@隨訪,隨訪時間12~18個月,平均13.3個月。X線片復查示,骨折均解剖復位,內(nèi)固定物位置滿意,踝關節(jié)各骨對應關系無異常,下脛腓聯(lián)合關系正常;骨折均愈合,愈合時間6~8周,平均7.6周。術后3~6個月復查踝關節(jié)MRI示三角韌帶形態(tài)正常。按美國足踝外科協(xié)會(AOFAS)評分:獲優(yōu)6例,良3例,可1例,差1例,優(yōu)良率81.8%。結(jié)論對于踝關節(jié)骨折伴三角韌帶損傷,切開復位內(nèi)固定骨折同時修補三角韌帶,可最大程度恢復踝關節(jié)內(nèi)側(cè)穩(wěn)定結(jié)構(gòu)。
[Abstract]:Objective to investigate the effect of surgical treatment of ankle fracture with deltoid ligament injury.Methods from January 2010 to January 2013, 11 cases of ankle fracture with deltoid ligament injury were treated.There were 7 males and 4 females with an average age of 38.2 years (1872 years).The time from injury to operation was 6 hours and 7 days, with an average of 4 days.According to Lauge-Hansen classification criteria, 5 cases of pronation and external rotation type, 4 cases of pronation and external rotation type, 2 cases of pronation and abduction type.Ankle color Doppler ultrasound and MRI confirmed the rupture of the triangular ligament.After anesthesia, valgus stress test, talus valgus tilt test and anterior drawer test were all positive.Ankle fractures were treated with open reduction and internal fixation, and deltoid ligament was explored and repaired.Results all the incisions healed in one stage and no infection occurred.All the patients were followed up for 12 ~ 18 months with an average of 13.3 months. X-ray examination showed that the fractures were all anatomically reduced, the internal fixation was satisfactory, the corresponding relationship of the ankle bones was not abnormal, the relationship between the lower tibiofibular syndesmosis was normal, the fractures were all healed.The healing time was 6 weeks, 8 weeks, with an average of 7.6 weeks.After 3 ~ 6 months, MRI of ankle showed normal shape of triangular ligament.According to AOFASA score: 6 cases were excellent, 3 cases were good, 1 case was fair, 1 case was poor, the excellent and good rate was 81.8%.Conclusion for ankle fracture with deltoid ligament injury, the medial stable structure of ankle joint can be recovered as much as possible by open reduction and internal fixation of the fracture and repair of the triangular ligament.
【作者單位】： 上海市靜安區(qū)中心醫(yī)院;復旦大學附屬華山醫(yī)院靜安分院骨科;
【基金】：上海市靜安區(qū)衛(wèi)生計生系統(tǒng)第3批“十百千”衛(wèi)生人才培養(yǎng)資助項目(JWRC2014Q03)~~
【分類號】：R687.3

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本文編號：1740984