后踝关节面解剖复位在踝关节骨折手术治疗中的临床意义

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1、后踝关节面解剖复位和内固定在踝关节骨折手术治疗中的临床意义施保华沈决心谭晚明上海市崇明县堡镇人民医院骨科202157【摘要】目的总结治疗踝关节骨折中后踝骨折的手术方法和治疗效果。方法自2005年3月-2010年6月，手术治疗后踝骨折54例。男36例，女18例；根据CT分类Ⅰ型36例，Ⅱ型10例，Ⅲ型8例。应用改良的Baird-Jackson评分系统对其术后疗效进行评定，并将骨折类型、骨折固定方法、术后功能锻炼时间与最终功能的关系进行分析。结果随访时间为6-36个月，平均18个月。54例疗效为：优29例，良18例，可5例，差2例，优良率为87.03%。除4例长时间行走有轻微疼痛外

2、，其余患者均无疼痛。结论手术治疗后踝骨折可取得满意的骨折复位和临床疗效，复位的质量与疗效密切相关，判断骨折类型和选择固定方法对于提高复位质量，改善远期疗效十分重要。【关键词】后踝骨折；解剖复位；内固定；踝关节骨折手术治疗TheclinicalsignificanceofanatomicreductionandinternalfixationofposteriormalleolarfractureinanklefracturesurgicaltreatmentSHIBaohuaSHENJuexinDepartmentofOrthopedics,ThePeople’sHospita

3、lofBaoZhen;ChongMing;ShangHai;202157AbstractObjectiveToevaluatetheclinicalsignificanceofanatomicreductionandinternalfixationofposteriormalleolarfractureinanklefracturesurgicaltreatmentMethodsFifty-fourpatientswithposteriormalleolarfractureweretreatedwithanatomicreductionandinternalfixationfr

4、omMarch2005toJune2010.Thepatientsgroupsconsistedof36malesand18females.AccordingtoCTscanclassification,thegroupwasmadeupof36typeⅠcases,10typeⅡand8typeⅢcases.AllpatientswereevaluatedwithmodifiedBaird-Jacksonscoringsystem.Therelationshipbetweenfinalresultandfracturepattern,fixationmethods,theti

5、meofexerciseinitiationfittedoperationwereanalyzedrespectively.ResultsThefollowed-upperiodvariedfrom6monthsto36months,withanaverageof18months.Thenumberofpatientswhoseresultwasexcellent,good,fairandpoorwasrespective29,18,5and2.Thetotalpercentageofgoodtoexcellentclinicalresultwas87.03%.Therewer

6、e4patientswhohadonlyslightpainafterlongtimewalking,theremainderpatientswerecompletedwithnopain.ConclusionOperativetreatmentmayprovidesatisfactoryfractureanatomicreductionandinternalfixationforposteriormalleolarfracture.Correctfracturepatternestimationandproperinternalfixationwereofimportantt

7、oachieveandimprovereductionquality,andtoamelioratebetterlongtermresults.Keywords　FracturesofPosteriormalleolus(FPM)AnatomicreductionInternalfixationAnklefracturesurgicaltreatment在所有踝关节骨折中，累及后踝的骨折占14％～44%[1]。后踝骨折常伴发内外踝骨折，单独发生的后踝骨折非常罕见[2]。踝关节骨折中后踝骨折较