目的 探讨手术治疗踝关节骨折合并下胫腓联合分离的效果。方法 回顾性分析2013-04至2016-10收治的42例踝关节骨折者合并下胫腓联合分离患者,均采用切开复位钢板、螺钉内固定,下胫腓联合采用1枚螺钉固定,术后8周取出固定下胫腓的螺钉。随访24个月,观察预后效果。结果 42例术后均获随访,随访时间10~24个月,平均18个月,骨折均愈合,无下胫腓联合再分离。AOFAS评分:优33例,良6例,可2例,差1例,优良率92.8%。结论 对于踝关节骨折合并下胫腓联合韧带损伤,除骨折有效固定外,术中恢复下胫腓联合的解剖复位及固定有利于提高骨折治疗的优良率,降低二次手术的发生率,值得临床推广应用。

Objective To explore the clinical effect of operative treatment for patients with ankle fractures complicated with syndesmosis ligament injury.Methods A total of 42 cases of patients with ankle fractures complicated with syndesmosis ligament injury admitted to our hospital between April 2013 and October 2016 were retrospectively studied. All the patients received operative treatment for ankle fractures complicated with syndesmosis ligament injury.Results Forty-two cases were followed up for 10 to 24 months and the average length of time was 18 months. According to the AOFAS scoring system, effects were evaluated as excellent in 33 cases, good in 6 cases, fair in 2 cases, so the excellent-good rate was 92.8%.Conclusions For patients with ankle fractures complicated with syndesmosis ligament injury, fixation of the internal and external malleolus combined with syndesmosis fixation by screws can effectively improve the excellent and good rates of fracture healing.