手术治疗旋后外旋型踝关节骨折

目的:探讨手术治疗旋后外旋型踝关节骨折的疗效.方法:2006年1月至2010年9月,手术治疗旋后外旋型踝关节骨折患者82例,于术后6个月和12个月时对患侧与健侧踝关节功能进行比较,并对术后6个月与术后12个月时的踝关节功能进行比较.结果:术后6个月时患侧踝关节功能明显差于健侧,差异有统计学意义(t=-8.286,P=0.000)；术后12个月时患侧踝关节功能接近健侧踝关节,差异无统计学意义(t=1.179,P=0.240).术后12个月时患侧踝关节功能较术后6个月时明显改善,差异有统计学意义(t=- 10.769,P=0.000)；术后12个月时健侧踝关节功能也较术后6个月时改善,差异有统计学意义(t=-6.819,P=0.000).结论:对损伤进行准确的评估、选择恰当的手术时机和合适的固定方法、恢复完整的关节面和关节的稳定、术后进行有效的功能锻炼,可以提高旋后外旋型踝关节骨折的手术疗效,有效恢复踝关节功能.

Study on the curative effect of operational treatment on the ankle joint fracture in supination-external rotation type

Objective：To explore the curative effect of operation on the ankle joint fracture in supination-external rotation type（S-E-R type）.Methods：Eighty-two cases with ankle joint fracture in S-E-R type were processed with operation from January 2006 to September 2010.The ankle joint functions were compared between the diseased side and the healthy side at the 6th and the 12th months after the operation respectively,The ankle joint functions at the 6th months after the operation were compared with that at the 12th months after the operation.Results：Six months after the operation,the ankle joint function of diseased side was worse than that of the healthy side,and there was statistical difference between them（t=-8.286,P=0.000）.Twelve months after the operation,the ankle joint function of diseased side was close to that of the healthy side,and there was no statistical difference between them（t=1.179,P=0.240）.Ankle joint function of diseased side at the 12th months after the operation was improved a lot compared with that at the 6th months after the operation,and there was statistical difference between them（t=-10.769,P=0.000）;and the same situation also occurred in the healthy side（t=-6.819,P=0.000）.Conclusion：It can improve the curative effects of operation on ankle joint fracture in S-E-R type and effectively recover the ankle joint functions through the following methods as accurate evaluation of the injuries,proper operation opportunity and fixation methods,the recovery of the complete articular surface and the stable ankle joints,effective functional exercises after the operation.