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-  2015 

手术治疗踝关节骨折伴三角韧带损伤的疗效观察

DOI: doi:10.7507/1002-1892.20150090

Keywords: 踝关节骨折, 三角韧带损伤, 内固定, 韧带修复

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Abstract:

目的探讨手术治疗踝关节骨折伴三角韧带损伤的疗效。 方法2010年1月-2013年1月,收治11例踝关节骨折伴三角韧带损伤患者。其中男7例,女4例;年龄18~72岁,平均38.2岁。受伤至手术时间为6 h~7 d,平均4 d。踝关节骨折根据Lauge-Hansen分型标准:旋前-外旋型5例,旋后-外旋型4例,旋前-外展型2例。踝关节彩色多普勒超声及MRI检查证实三角韧带断裂。麻醉后行外翻应力试验、距骨外翻倾斜试验和前抽屉试验均为阳性。踝关节骨折行切开复位内固定,探查并修复三角韧带。 结果术后切口均Ⅰ期愈合,无感染等手术相关并发症发生。患者均获随访,随访时间12~18个月,平均13.3个月。X线片复查示,骨折均解剖复位,内固定物位置满意,踝关节各骨对应关系无异常,下胫腓联合关系正常;骨折均愈合,愈合时间6~8周,平均7.6周。术后3~6个月复查踝关节MRI示三角韧带形态正常。按美国足踝外科协会(AOFAS)评分:获优6例,良3例,可1例,差1例,优良率81.8%。 结论对于踝关节骨折伴三角韧带损伤,切开复位内固定骨折同时修补三角韧带,可最大程度恢复踝关节内侧稳定结构

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