摘要
目的 探讨踝关节三柱分型指导踝部骨折内固定的临床效果。方法 回顾性分析2014年1月至2016年1月收治的32例踝关节骨折患者的临床资料。根据影像学表现的病理解剖特点及受伤机制,将踝关节按形态分为三柱,其中外侧柱骨折32处,中间柱韧带损伤11处,中间柱撕脱骨折15处,内侧柱韧带损伤9处,内侧柱骨折16处。根据三柱理论设计手术入路及内固定,三柱骨折至少固定两柱。术后6个月疼痛VAS评分,骨折复位固定术后的影像学评价采用改良Baird和Jackson评估标准,踝关节功能评价采用美国足踝外科医师协会（AOFAS）踝-后足评分系统。结果 32例患者获得随访,随访时间6-24个月（平均18个月）,骨折愈合时间为11-15周（平均13.5个周）,疼痛VAS评分为0-6分（平均1.3分）,术后随访踝关节功能（AOFAS）踝-后足评分：82-100分,平均97分。X线疗效评定：优28例,良4例,优良率为100%。结论 踝部骨折中根据三柱分型设计手术入路及内固定方式可以较好显露及固定骨折,恢复踝关节功能。
Objective To study the guidance of three column theory in decision making of ankle joint fracture and its result. Methods A total of 32 eases of ankle joint fracture classified by three eolum method and treated by open reduction internal fixation （ORIF） were reviewed from January 2014 to January 2016.Among all the ankle joint fracture,the lateral column fracture in 32,middle column ligament injury in 11, middle column avulsion fracture in 15,the inner side column ligament injury in 9,medial column fracture in 16. In the three column injury at least two column were fixed. Results Thirty-two eases had been followed up.The average follow-up time was 18 months ranging between 6.0 and 24.0 months.The average healing time wan 13.5 weeks ranging from 11.0 to 15.0 weeks.The pain VAS score ranged from 0 to 6 （mean 1.3）.Postoperative follow-up of ankle function ,ankle hind foot score from 82 to 100 （mean 97） points according to AOFAS evaluation system,an average of 96 braneh.Radiological evaluation of curative effect：excellent in 28cases,good in 4cases, the excellent and good rate was 100%,according to Baird and Jackson＇s radiology evaluation system. Conclusion According to three column theory design surgical approach and internal fixation the ankle fracture can better show and fixation,ankle joint function recovery.
出处
《足踝外科电子杂志》
2016年第2期15-21,25,共8页
Electronic Journal of Foot and Ankle Surgery
关键词
踝关节骨折
三柱理论
内固定
功能评价
Ankle fracture
Three column theory
Internal fixation
Functional assessment
