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

【摘要】：目的探討手術(shù)治療踝關(guān)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(guān)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(shù)時(shí)間為6 h~7 d,平均4 d。踝關(guān)節(jié)骨折根據(jù)Lauge-Hansen分型標(biāo)準(zhǔn):旋前-外旋型5例,旋后-外旋型4例,旋前-外展型2例。踝關(guān)節(jié)彩色多普勒超聲及MRI檢查證實(shí)三角韌帶斷裂。麻醉后行外翻應(yīng)力試驗(yàn)、距骨外翻傾斜試驗(yàn)和前抽屜試驗(yàn)均為陽(yáng)性。踝關(guān)節(jié)骨折行切開復(fù)位內(nèi)固定,探查并修復(fù)三角韌帶。結(jié)果術(shù)后切口均Ⅰ期愈合,無(wú)感染等手術(shù)相關(guān)并發(fā)癥發(fā)生。患者均獲隨訪,隨訪時(shí)間12~18個(gè)月,平均13.3個(gè)月。X線片復(fù)查示,骨折均解剖復(fù)位,內(nèi)固定物位置滿意,踝關(guān)節(jié)各骨對(duì)應(yīng)關(guān)系無(wú)異常,下脛腓聯(lián)合關(guān)系正常;骨折均愈合,愈合時(shí)間6~8周,平均7.6周。術(shù)后3~6個(gè)月復(fù)查踝關(guān)節(jié)MRI示三角韌帶形態(tài)正常。按美國(guó)足踝外科協(xié)會(huì)(AOFAS)評(píng)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(duì)于踝關(guān)節(jié)骨折伴三角韌帶損傷,切開復(fù)位內(nèi)固定骨折同時(shí)修補(bǔ)三角韌帶,可最大程度恢復(fù)踝關(guān)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(fù)旦大學(xué)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(jì)生系統(tǒng)第3批“十百千”衛(wèi)生人才培養(yǎng)資助項(xiàng)目(JWRC2014Q03)~~
【分類號(hào)】：R687.3

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本文編號(hào)：1740984