北京生物医学工程

后踝骨折生物力学分析与临床实践

Biomechanical analysis and clinical practice ofposterior malleolus fracture

作者：许有银王建光吴俊贤李玉民

单位：民航总医院骨科(北京100123)

分类号：318.01;R683.42

出版年·卷·期（页码）：2020·39·3（303-307）

摘要：

目的通过对后踝骨折内固定与非内固定疗效的生物力学分析,探讨影响后踝骨折疗效的主要因素?方法选取民航总医院骨科2011年4月至2019年1月56例累及后踝关节骨折患者的临床资料进行回顾性分析?将56例患者分为后踝骨折内固定组(后踝骨折块≥25%的胫骨远端关节面,27例)与非内固定组(后踝骨折块<25%胫骨远端关节面,29例),比较两组患者的治疗效果?结果 56例患者12~30个月的随访结果表明,踝关节骨折均愈合?后踝骨折块≥25%和<25%胫骨远端关节面均得到解剖学复位,两组差异无统计学意义(P>05),AOFAS踝-后足评分差异无统计数学意义(P>05)?结论后踝骨折块≥25%的胫骨远端关节面或移位大于2mm时,应手术切开复位内固定;后踝骨折块<25%胫骨远端关节面可石膏外固定治疗?因此,在临床后踝骨折的患者可根据患者的具体情况选择合适的治疗方案,以取得更好的治疗效果?

Objective To investigate the main factors influencing the curative effect of the posterior

Malleolus fracture by the biomechanical analysis of the internal fixation and nonfixation of the posterior malleolus fracture.Methods From April 2011 to January 2019, the clinical data of 56 patients with posterior malleolus fracture were analyzed retrospectively。They were divided into two groups:fixed group(27cases) and nonfixed group (29 cases). The therapeutic effect of the two groups was compared. Results 56 patients were followed up for 12 to 30 months. All ankle fractures healed.The difference in anatomic reduction between ≥25% and <25% was not statistically significant (P>05). The difference in AOFAS score was not statistically significant (P>05).Conclusions When the posterior in malleolus fracture mass ≥25% of the distal tibial　Joint surface or displacement > 2mm, open reduction and internal fixation should be performed. When the posterior malleolus fracture <25% of the distal tibial joint surface can be treated by plaster external fixation. Therefore. In the clinical patients with posterior malleolus fracture, we can choose the appropriate treatment plan according to the specific situation of the patients, so as to achieve better treatment effect.

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