手术治疗踝关节旋后—外旋Ⅳ度损伤的临床分析

手术治疗踝关节旋后—外旋Ⅳ度损伤的临床分析【摘要】 目的 回顾分析手术复位螺钉内固定治疗踝关节旋后—外旋Ⅳ度损伤的治疗疗效。方法 自 1998 年 5 月～2025年 3 月，共手术治疗 37 例踝关节旋后—外旋Ⅳ度损伤，获随访 33 例，随访时间 12～40 个月，平均 18 个月，男 21 例，女 12 例；年龄 17～68 岁，平均 38 岁。左侧 18 例，右侧 15 例，均为单侧。其中内踝骨折 31 例，行拉力螺钉内固定，2 例无内踝骨折为单纯三角韧带撕裂，作韧带修补。后踝骨折 27例，其中 17 例作拉力螺钉内固定，10 例因骨折块移位＜1mm 未作复位固定，6 例无后踝骨折。33 例外踝骨折，用 2 枚皮质骨螺钉过骨折线固定。共有 4 例行下胫腓联合固定，用 1 枚拉力螺钉过 3 层皮质固定。所有病例术后石膏托辅助固定 4～6 周。结果 用 Mazur 踝关节症状与功能评分系统评判，优 23 例，良 7 例，可 3 例，无差。优良率91%。结论 手术复位螺钉内固定治疗踝关节旋后—外旋Ⅳ度损伤具有优良疗效。【关键词】 踝关节；骨折；内固定 【Abstract】 Objective To analyse the result of operated for stage Ⅳ supination-external rotation ankle Thirty-seven cases of stage Ⅳ supination-external rotation ankle injury were operation from May 1998 to Mar cases were followed-up for a period of average of 18 months from 12 months to 40 were 21 males and 12 cases were of left and 15 of cases of malleolus fractures were operated by screw fixation，2 cases of simple triangle ligament lacerations without medial malleolus fractures were operated by ligament cases of posterior malleolus fractures，among them，17 cases were fixed with screw，10 cases of fracture displacement less than 1mm were not reduced and cases without posterior malleolus cases of lateral malleolus fractures were fixed with two screws through fracture 33 cases，4 cases of the distal tibiofibular syndesmosis were fixed with one screw through three layers of bone cases were auxiliary fixed with plaster pad for 4～6 wee...