【摘要】 目的 :对陈旧性踝关节骨折手术治疗的远期疗效进行分析 ,确定恰当的治疗方案。方法 :对 46例陈旧性踝关节骨折患者施行手术治疗 ,3 7例行切开复位内固定 ,9例行踝关节融合术 ,应用AOFAS评分系统进行评分。结果 :随访 2 6～ 12 1个月 ,平均 87个月。远期疗效良好 ,骨折全部愈合 ,无痛可负重。但延迟 1～ 3个月手术AOFAS评分术后较术前明显提高 ,延迟三个月以上者术后较术前无明显提高。结论 :延迟 1～ 3个月手术的踝关节骨折如踝穴恢复完整并获得解剖复位或接近解剖复位宜行关节切开复位内固定术 ;否则宜行关节融合术。延迟三个月以上手术的骨折 ,由于软骨和软组织发生退变 ,难以获得解剖复位 ,宜行关节融合术更多还原

【Abstract】 Objective:Analysis of the late results of the old ankle fractures with surgery to determine the effective treatment.Methods:46 patients with old ankle fractures with surgery were reviewed.37 patients treated by open reduction and internal fixation,9 treated by arthrodesis.All of the patients were evaluated by AOFAS rating system.Results:All of the 46 patients were followed up from 26 months to 121 months,with an average of 87 months.The late results were better,all of the fractures headled up and the patients have had painless joints.Compared with the arthrodesis,the patients treated by open reduction and internal fixation with 1-3 months had higher AOFAS scores.However,there was no significant defference between the final results following there two operative procedures in AOFAS socre if the surgery was delayed over 3 morths.Conclusion:In the case of fracture of the ankle with delayed treatment of 3 months,anatomical reduction can be attained by open reduction and internal fixation.Otherwise,arthrodesis should be considered.Anatomical reduction is difficult because the degenerative changes of the cartilage and the soft tissuee,so for the delayed treatment of displaced ankle fracture,arthrodesis is the best choice.更多还原