摘要
目的 探讨胫骨干骨折伴同侧无移位的后踝骨折的损伤机制与防治。方法 2001年5月至2004年11月，共收治34例胫骨干骨折伴后踝骨折，2例为开放性骨折。手术前摄胫腓骨全长和踝关节x线片，发现或怀疑有后踝骨折者，均予CT检查，术中先予后踝骨折块经皮螺钉固定，再行胫骨髓内钉手术治疗。结果所有患者平均随访时间11个月。33例患者骨折愈合良好，踝关节功能优良。1例患者术前漏诊，随访时发现后踝骨折，踝关节疼痛功能差。结论胫骨干合并后踝骨折在临床常见，后踝骨折漏诊是后期踝关节功能障碍的主要原因，术前踝关节CT检查及术中后踝精确固定是防治的关键。
Objective To discuss the cause and prevention of the tibial shaft fracture associated with ipsilateral posterior malleolus fracture. Methods From May 2001 to November 2004, 269 cases of tibial shaft fracture were treated in our department. Of them, 34 were complicated with ipsilateral posterior malleolus fracture. They were 21 males and 13 females. Their ages ranged from 33 to 71 years old. There were 2 patients with tibial open fracture. Preoperatively conventional plain X-ray of the full-length tibia and ankle region was taken for all the patients. CT scanning was conducted for those who were suspected of the ipsilateral posterior malleolus fracture. Before tibial intramedulary nailing, the posterior malleolar fragments were fixed with an anterior lag-screw. Results The mean duration of follow-up was 11 months. The posterior malleolus fracture healed with excellent ankle function in 33 cases. The only one case whose posterior malleolus fracture had been overlookd until follow-up sufferd from ankle disfunction and pain. Conclusions The tibial shaft fracture is frequently complicated with and the ipsilateral posterior malleolus fracture in clinic which is responsible for the ankle disfunction. Pre-operative CT scanning of the ankle and fixation of the fragments are key elements of the prevention.
出处
《中华创伤骨科杂志》
CAS
CSCD
2009年第2期136-138,共3页
Chinese Journal of Orthopaedic Trauma
关键词
胫骨骨折
踝损伤
骨折固定术
髓内
Tibial fracture
Ankle injuries
Fracture fixation, intramedullary
