[1]杨玉起,王金刚,李 虎,等.三踝骨折手术治疗的临床分析[J].医学信息,2018,31(15):185-186189.[doi:10.3969/j.issn.1006-1959.2018.15.063]
　YANG Yu-qi,WANG Jing-gang,LI Hu,et al.Clinical Analysis of Surgical Treatment of Trimalleolar Fractures[J].Journal of Medical Information,2018,31(15):185-186189.[doi:10.3969/j.issn.1006-1959.2018.15.063]
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三踝骨折手术治疗的临床分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
31卷
期数:
2018年15期
页码:
185-186189
栏目:
出版日期:
2018-08-01

文章信息/Info

Title:
Clinical Analysis of Surgical Treatment of Trimalleolar Fractures
文章编号:
1006-1959（2018）15-0185-03
作者:
杨玉起; 王金刚; 李 虎; 杨巍巍; 陈 勇; 杨 林
安徽省阜南县中医院骨科，安徽 阜南 226300
Author(s):
YANG Yu-qi; WANG Jing-gang; LI Hu; YANG Wei-wei; CHEN Yong; YANG Lin
Department of Orthopaedics,Funan County of Traditional Chinese Medicine Hospital,Funan 226300,Anhui,China
关键词:
三踝骨折; 外侧入路; 内测入路; 切开复位内固定术
Keywords:
Key words：Trimalleolar fracture; Lateral approach; Internal approach; Open reduction and internal fixation
分类号:
R683.42
DOI:
10.3969/j.issn.1006-1959.2018.15.063
文献标志码:
B
摘要:
目的 总结分析三踝骨折骨折的治疗方法、疗效和临床经验，为三踝骨折的外科治疗提供指导。方法 回顾分析我院2015年3月~ 2017年10月采用切开复位+内固定治疗的21例三踝骨折患者，所有患者外踝骨折经踝关节外侧切口复位后腓骨远端解剖锁定钢板固定，后踝和内踝均通过后内侧切口复位，患者术前、术后均行踝关节正侧位摄片检查，末次随访时根据美国足踝外科协会（AOFAS）足踝评分系统对踝关节功能进行疗效评定。结果 5例患者存在下胫腓联合损伤并均采用下胫腓螺钉固定。21例患者均获得骨折愈合，骨折愈合时间12~16周，平均骨折愈合时间（13.82±3.56）周。AOFAS足踝得分70~97分，平均AOFAS足踝得分为（90.70±6.78）分，其中优12例，良8例，可1例，无感染、骨不连、骨折畸形愈合、内固定松动等并发症。结论 三踝骨折患者经外侧入路结合后内测入路切开复位内固定治疗可以获得满意的临床疗效。
Abstract:
Abstract：Objective To summarize and analyze the treatment, curative effect and clinical experience of trimalleolar fracture,and to provide guidance for surgical treatment of trimalleolar fracture.Methods 21 cases of trimalleolar fractures treated by open reduction+ internal fixation in our hospital from March 2015 to October 2017 were retrospectively analyzed.The lateral malleolus fractures of all patients were fixed by lateral ankle incision,and the distal fibular fractures were fixed with anatomical locking plates.The posterior malleolus and the medial malleolus were repositioned through the posterior medial incision.The patients were examined before and after the operation,and the ankle joint function was evaluated according to the American Ankle Surgery Association(AOFAS)foot and ankle scoring system at the last follow-up.Results 5 patients had lower tibiofibular joint injuries and were treated with lower tibiofibular screw fixation.Fracture healing was achieved in all 21 patients.The healing time was 12 to16 weeks,and the average healing time was(13.82±3.56)weeks.The score of AOFAS foot and ankle was 70 to 97.The average score of AOFAS foot and ankle was (90.70±6.78)points,of which 12 cases were excellent,8 cases were good,1 case was average,no infection,bone nonunion,fracture malunion,internal fixation loosening and so on.Conclusion The treatment of trimalleolar fracture with open reduction and internal fixation through lateral approach combined with posterior internal measurement approach can achieve satisfactory clinical results.

参考文献/References:

[1]Kitaoka HB,Alexander IJ,Adelaar RS,et al.Clinical rating systems for the ankle-hindfoot, midfoot,hallux,and lesser toes[J].Foot&ankle international.American Orthopaedic Foot and Ankle Society and Swiss Foot and Ankle Society,1994,15(7):349-353.
[2]刘洪新,王文跃,朱海涛,等.手术治疗三踝骨折17例体会[J].临床骨科杂志,2013,16(4):232.
[3]王亦璁,姜保国.骨与关节损伤[M].第5版.北京：人民卫生出版社,2012:1429-1430.

相似文献/References:

[1]于 洋.改良踝关节后外侧入路联合内侧复位固定治疗三踝骨折的临床效果[J].医学信息,2022,35(22):112.[doi:10.3969/j.issn.1006-1959.2022.22.024]
　YU Yang.Clinical Effect of Modified Posterolateral Approach of Ankle Joint Combined with Medial Reduction and Fixation in the Treatment of Trimalleolar Fracture[J].Journal of Medical Information,2022,35(15):112.[doi:10.3969/j.issn.1006-1959.2022.22.024]

更新日期/Last Update: 2018-08-01