[胫腓下联合损伤的诊断与治疗研究进展]
[Research progress in diagnosis and treatment of distal tibiofibular syndesmosis injury].
作者信息
Huang Hui, Yang Yunfeng
机构信息
Department of Orthopaedics, Tongji Hospital, Tongji University, Shanghai, 200065, P.R.China.
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Oct 15;34(10):1346-1351. doi: 10.7507/1002-1892.201911090.
OBJECTIVE
To review the research progress in the diagnosis and treatment of distal tibiofibular syndesmosis injury.
METHODS
The recent literature about distal tibiofibular syndesmosis injury was reviewed and analyzed.
RESULTS
Distal tibiofibular syndesmosis injury is commonly seen in ankle joint injury, the anatomical complexities make diagnosis and treatment difficult. Preoperative physical examination, radiologic evaluation, and intraoperative stress-testing are important for the diagnosis. Aggressive treatment is also recommended for these injuries to prevent long-term chronic instability. Internal fixation is the main treatment, including metal screw, degradable screw, elastic fixation, and hybrid techniques. Metal screw fixation is still the current mainstream, but elastic fixation represented by Suture-button is more in line with the physiological characteristics of ankle joint, and the rate of secondary operation is low while the clinical outcome is satisfactory. The application prospect of elastic fixation is worthy of expectation.
CONCLUSION
It's crucial for patient with ankle fracture to repair the distal tibiofibular syndesmosis injury. How to diagnose the injury more accurately and simply, how to increase the success rate of reduction, and how to reduce the complications of surgery are still worthy for further exploration.
目的
综述下胫腓联合损伤的诊断与治疗研究进展。
方法
回顾并分析近期有关下胫腓联合损伤的文献。
结果
下胫腓联合损伤在踝关节损伤中较为常见，其解剖结构复杂，导致诊断和治疗困难。术前体格检查、影像学评估及术中应力试验对诊断很重要。对于这些损伤也建议积极治疗以预防长期慢性不稳定。内固定是主要治疗方法，包括金属螺钉、可降解螺钉、弹性固定及混合技术。金属螺钉固定仍是目前的主流，但以缝合纽扣为代表的弹性固定更符合踝关节的生理特点，二次手术率低且临床效果满意。弹性固定的应用前景值得期待。
结论
踝关节骨折患者修复下胫腓联合损伤至关重要。如何更准确、简便地诊断损伤，如何提高复位成功率，以及如何减少手术并发症仍值得进一步探索。
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