[1]梁羽 何荣富 刘绍江 王川 李林涛 钟凤林△.复杂踝关节骨折复位不佳的原因及预防策略[J].中国中医骨伤科杂志,2020,28(04):20-23.
　LIANG Yu HE Rongfu LIU Shaojiang WANG Chuan LI Lintao ZHONG Fenglin.Causes and Preventive Strategies of Malreduction of Complex Ankle Fractures[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2020,28(04):20-23.
点击复制

复杂踝关节骨折复位不佳的原因及预防策略()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第28卷
期数:
2020年04期
页码:
20-23
栏目:
临床研究
出版日期:
2020-04-06

文章信息/Info

Title:
Causes and Preventive Strategies of Malreduction of Complex Ankle Fractures
文章编号:
1005-0205(2020)04-0020-04
作者:
梁羽1 何荣富1 刘绍江1 王川1 李林涛1 钟凤林1△
1四川攀枝花市中心医院(四川 攀枝花,617067) △通信作者 E-mail:416815606@qq.com
Author(s):
LIANG Yu1 HE Rongfu1 LIU Shaojiang1 WANG Chuan1 LI Lintao1 ZHONG Fenglin1△
1Department of Orthopeadic, Panzhihua Central Hospital, Panzhihua 617067,Sichuan China.
关键词:
踝关节骨折;  切开复位;  复位不良;  失败
Keywords:
ankle fracture;  open reduction;  malreduction;  failure
分类号:
R683.42
文献标志码:
A
摘要:
目的:分析复杂踝关节骨折复位不良的原因及预防策略。方法:回顾性分析自2016年1月至2019年1月行切开复位内固定的复杂踝关节骨折患者61例,男29例,女32例; 年龄28～68岁,平均46.7岁,所有骨折均属于三柱损伤。结果:12例复杂踝关节骨折复位不良,失败率为19.67%,其中:外踝短缩畸形2例,外踝旋转畸形4例,下胫腓联合损伤漏诊6例。结论:复杂踝关节骨折损伤重,手术复杂,腓骨长度的恢复和旋转畸形的纠正对下胫腓联合损伤的修复十分关键,而下胫腓联合损伤的诊断及精确治疗对维持踝关节的长期稳定和降低踝关节远期创伤性关节炎十分重要。
Abstract:
Objective:To analyze the causes and preventive strategies of malreduction of complex ankle fractures. Methods: 61 patients with complicated ankle fracture were treated by open reduction and internal fixation in orthopedic department from January 2016 to January 2019. These patients included 29 males and 32 females, and their mean age was 46.7 years old(28～68 years old). According to the three-column classification, all fractures were three-column injuries. Results:12 patients with complex ankle fractures had poor reduction, with a failure rate of 19.67%, including 2 cases of lateral ankle shortening deformity, 4 cases of lateral malleolus rotation deformity, and 6 cases of misdiagnosis of syndesmotic disruption. Conclusion:Complex ankle fractures have characterized by serious injury and the operation is complicated. Anatomic reduction of the fibular length and rotation are essential for repair of combined tibiofibular injury. Furthermore, the accuracy diagnosis and treatment of combined tibiofibular injury are very important to maintain the stability of the ankle and reduce the traumatic arthritis of the joint in the future.

参考文献/References:

[1] MOODY M L,KOENEMAN J,HETTINGER E,et al.The effects of fibular and talar displacement on joint contact areas about the ankle[J]. Orthop Rev,1992,21(6):741-744.
[2] ROBERTS V,MASON L W,HARRISON E,et al.Does functional outcome depend on the quality of the fracture fixation? Mid to long term outcomes of ankle fractures at two university teaching hospitals[J].Foot and Ankle Surgery,2019,25(4):538-541.
[3] FUTAMURA K,BABA T,MOGAMI A,et al.Malreduction of syndesmosis injury associated with malleolar ankle fracture can be avoided using Weber's three indexes in the mortise view[J].Injury,2017,48(4):954-959.
[4] 王朝亮,黄素芳,朱涛,等.三柱理论在踝关节骨折合并下胫腓联合损伤治疗中的应用[J].中华解剖与临床杂志,2016,21(3):236-241.
[5] PAKARINEN H,FLINKKILÄ T,OHTONEN P,et al.Intraoperative assessment of the stability of the distaltibiofibular joint in supination-external rotation injuries of the ankle:sensitivity,specificity,andreliability of two clinical tests[J].J Bone Joint Surg Am,2011,93(22):2057-2061.
[6] MIZEL M S.Technique tip:a revised method of the Cotton test for intra-operative evaluation ofsyndesmotic injuries[J].Foot Ankle Int,2003,24(1):86-87.
[7] 周松,赵鹏飞,刘延霞,等.踝关节骨折术后功能障碍原因分析[J].中国中医骨伤科杂志,2003,11(5):36-37.
[8] 姜保国.踝关节骨折治疗进展[J].中华创伤杂志,2008,24(5):321-322.
[9] 张宏宁,朱永展,李雪,等.踝关节骨折中外踝移位对胫距关节接触影响的三维有限元分析[J].中华创伤骨科杂志,2017,19(9):769-774.
[10] SCOLARO J A,ZAMORANO D P.Management after failed treatment of ankle fracture[J].Current Orthopaedic Practice,2014,25(3),221-226.
[11] 董玉金,张铁慧,钟声.带线锚钉修复踝关节骨折合并三角韧带断裂[J].中华骨科杂志,2017,37(22):1385-1391.
[12] WEBER B G.Die Verletzungen des oberen sprunggelenkes[J].Aktuelle Probleme in der Chirurgie,1972,3:103-107.
[13] JENKINSON B J,SANDERS D W,MACLEOD M D,et al.Intraoperative diagnosis of syndesmosis injuries in external rotation ankle fractures[J].J Orthop Trauma,2005,19(9):604-609.
[14] 芦浩,徐海林,姜保国,等.下胫腓钩与Suture-button技术治疗下胫腓联合损伤[J].中华创伤杂志,2015,31(2):117-120.
[15] 邱海滨,江军,PORTER D.下胫腓联合损伤的术中分型和内固定选择[J].中华创伤骨科杂志,2017,19(9):739-745.
[16] 楼宇梁,洪建军,邵希文,等.Endobutton与螺钉内固定治疗下胫腓联合分离的临床疗效分析[J].中国骨伤,2016,29(8):729-733.
[17] SOIN S P,KNIGHT T A,DINAH A F,et al.Suture-button versus screw fixation in asyndesmosis rupture model:a biomechanical comparison[J].Foot Ankle Int,2009,30(4):346-352.
[18] LITZMAN R,ZHAO H,ZHANG L Q,et al.Suture-button versus screw fixation of the syndesmosis:a biomeehanical analysis[J].Foot Ankle Int,2010,31(1):69-75.
[19] COSGROVE C T,PUTNAM S M,CHERNEY S M,et al.Medial clamp tine positioning affects ankle syndesmosis malreduction[J].Journal of Orthopaedic Trauma,2017,31(8):440-446.

备注/Memo

备注/Memo:
(收稿日期:2019-09-08)
更新日期/Last Update: 2020-04-06