【摘要】 目的探讨后外侧入路切开复位内固定治疗后踝骨折的手术方法和临床疗效。方法 2010年2月至2015年2月,采用后外侧入路切开复位内固定治疗34例后踝骨折。根据Lauge-Hansen踝关节骨折分型,旋后-外旋型22例,旋前-外旋型10例,旋前-外展型2例。其中,15例患者采用钢板固定,19例患者采用空心螺钉固定。结果34例患者获得随访6~24个月,平均12个月。所有病例均达到骨性愈合,无内固定断裂及松动等并发症出现。1例患者出现切口浅表感染,经换药后切口愈合;其余患者切口均Ⅰ期愈合。末次随访采用美国矫形足踝协会(AOFAS)踝-后足评分标准进行功能评估,优11例,良17例,中6例,优良率为82.4%。结论后外侧入路切开复位内固定是治疗后踝骨折的一种良好方法,其显露清晰,可对后踝骨块精确复位并牢固固定,满意度高。更多还原

【Abstract】 Objective To investigate the operative procedure and clinical effectiveness of posterior malleolus fractures by open reduction and internal fixation via the posterolateral approach. Methods Between February 2010 to February 2015,34 patients with posterior malleolar fractures were treated with open reduction and internal fixation via the posterolateral approach,Fractures were classified with Iauge- Hansen classification system: supination- external rotation in 22 cases,pronation- external rotation in 10 cases and pronation- abduction in 2 cases. 15 patients were treated with plate fixation,19 patients were treated with hollow screws fixation. Results All cases were followed up for 6 ~ 24 months,with an average of 12 months. All cases obtained bone union,with no occurrence of complications such as breaking and loosening of internal fixation. 1 case suffered from superficial infection,which was cured after dressing change,and the other incisions achieved primary healing. At the final follow- up,According to the ankle- hind foot scale of American Orthopaedic Foot and Ankle Society( AOFAS),11 cases were graded as excellent,17 as good,6 as fair,and the excellent and good rate 82. 4%. Conclusion It is a favorable way to treat posterior malleolus fracture with open reduction and internal fixation via the posterolateral approach,which provides good surgical exposure,accurate fracture reduction and stable fixation,high degree of satisfaction.更多还原