Xing Wenzhao, Wang Yanfeng, Sun Liang, Wang Linjie, Kong Zhigang, Zhang Chunpu, Zhang Zhiguo
Department of Orthopaedics, Hebei Medical University Third Affiliated Hospital Department of Orthopaedics, Affiliated Hospital of Hebei University, Shijiazhuang, China.
Medicine (Baltimore). 2018 Sep;97(37):e12079. doi: 10.1097/MD.0000000000012079.
To explore the therapy of ankle joint dislocation treating dislocated trimalleolar fractures accompanied with the complex posterior malleolus fracture without separation of the tibiofibular syndesmosis and improve surgical results.Patients who had dislocated trimalleolar fractures accompanied with the complex posterior malleolus fracture without separation of the tibiofibular syndesmosis were retrospectively analyzed and 30 patients were enrolled the study. They were all treated by ankle joint dislocation and the surgical results were evaluated by the Baird-Jackson ankle scoring system. Longitudinal curved incision in medial malleolus was made in ankle joint dislocation and subluxation was automatically formed by appropriate traction of ankle joint. The talus and the distal end of internal and external malleolus were pushed the outside to form the lateral dislocation of the ankle joint. After fully revealed the posterior malleolus and distal articular surface of the tibia, the anatomical reduction of comminuted bones with joint cartilage and posterior malleolus was achieved by fixed with absorbable screw or Kirschner wire. Internal and external malleolus fracture was fixed by the conventional approach.The average follow-up period was 13 months. According to the Baird-Jackson ankle scoring system, the excellent and good result was 28 cases, fair was 2 cases which the excellent and good rate was 93.3% without talar necrosis in any cases.Ankle joint dislocation can achieve the satisfactory results in treating dislocated trimalleolar fractures accompanied with the complex posterior malleolus fracture without separation of the tibiofibular syndesmosis. Ankle joint dislocation can make joint cartilage restore accurately with excellent results.
探讨踝关节脱位治疗伴有复杂后踝骨折且胫腓下联合无分离的三踝骨折的方法，并提高手术效果。回顾性分析伴有复杂后踝骨折且胫腓下联合无分离的三踝骨折脱位患者，纳入研究30例。均采用踝关节脱位治疗，采用Baird-Jackson踝关节评分系统评估手术效果。踝关节脱位及半脱位时在内踝作纵弧形切口，通过适当牵引踝关节自动形成半脱位。将距骨及内外踝远端向外推形成踝关节外侧脱位。充分显露后踝及胫骨远端关节面后，用可吸收螺钉或克氏针固定使关节软骨及后踝粉碎性骨折解剖复位。内外踝骨折采用常规方法固定。平均随访13个月。根据Baird-Jackson踝关节评分系统，优28例，良2例，优良率93.3%，无1例发生距骨坏死。踝关节脱位治疗伴有复杂后踝骨折且胫腓下联合无分离的三踝骨折脱位可取得满意效果。踝关节脱位可使关节软骨准确复位，效果优良。
