Yang Yunfeng, Zhou Jiaqian, Li Bing, Zhao Hongmou, Yu Tao, Yu Guangrong
Department of Orthopaedics, Tongji Hospital, Tongji University, Shanghai, 200065, P.R. China.
Acta Ortop Bras. 2013 Mar;21(2):103-8. doi: 10.1590/S1413-78522013000200007.
To investigate the surgical methods in treating Weber type C ankle injury and estimate the necessity of syndesmosis operative exploration.
Forty three patients of Weber type C ankle injury were treated with open reduction and internal fixation from October 2004 to December 2009. Twenty nine patients were treated with routine procedure by open reduction and internal fixation, syndesmosis exploration and repair were performed in addition in the others. Thirty four patients were followed during an average time of 31.2 months (range 18 to 50 months), amomg them 22 patients were treated with routine procedures and 12 were treated with additional syndesmosis surgical exploration.
All the fractures were reunited in an average time of 13.1 weeks (range 10 to 18 weeks) and full weight bearing began. The mean ankle and hindfoot scale of the American Orthopaedic Foot and Ankle Society (AOFAS) score was 79.86(range 65 to 98) in the routine procedures group and 86.67 (range 78 to 100) in the syndesmosis exploration group and Olerud-Molander score was 77.27 (range 55 to 100) and 86.67 (range 75 to 100) respectively. Statistically significant difference was found between the two groups (P<0.05).
Syndesmosis surgical exploration is an essential treatment in some Weber type C ankle injuries, which make debridement and direct reduction of the syndesmosis possible, providing thus a more stabilized ankle joint. Level of Evidence III, Retrospective Comparative Study.
探讨Weber C型踝关节损伤的手术治疗方法,并评估下胫腓联合手术探查的必要性。
2004年10月至2009年12月,43例Weber C型踝关节损伤患者接受切开复位内固定治疗。29例患者采用常规切开复位内固定手术,其余患者在此基础上进行下胫腓联合探查与修复。34例患者获得随访,平均随访时间31.2个月(18至50个月),其中22例接受常规手术,12例接受下胫腓联合手术探查。
所有骨折均在平均13.1周(10至18周)内愈合,并开始完全负重。常规手术组美国矫形足踝协会(AOFAS)踝关节与后足评分平均为79.86(65至98分),下胫腓联合探查组为86.67(78至100分);Olerud-Molander评分分别为77.27(55至100分)和86.67(75至100分)。两组间差异有统计学意义(P<0.05)。
下胫腓联合手术探查是部分Weber C型踝关节损伤的必要治疗手段,可对下胫腓联合进行清创和直接复位,从而提供更稳定的踝关节。证据级别III,回顾性比较研究。