CAJ | 학술논문

目的：探讨改良后外侧入路在三踝骨折治疗中的临床疗效。方法2010年10月～2012年10月对32例三踝骨折的病例采用改良的后外侧入路行切开复位内固定治疗。根据Lauge-Hansen踝关节骨折分型，旋后外旋型18例，旋前外旋型14例。观察术后伤口愈合、骨折恢复及内固定情况，同时按Phillips踝关节评分标准踝关节功能进行评估。结果本组随访12～18个月，骨折全部愈合，愈合时间为10～13周。术后切口表浅感染1例。根据术后踝关节功能根据Phillips踝关节评分标准，本组评分为110～150分，平均（140.7±5.5）分；获优20例，良好7例，一般4例，差1例，优良率为84.3%。结论改良的踝关节后外侧手术入路不仅可充分显露后踝骨折，同时可兼顾外踝骨折的整复固定，减少手术切口及损伤，术野显露清晰，值得临床推广。
목적：탐토개량후외측입로재삼과골절치료중적림상료효。방법2010년10월～2012년10월대32례삼과골절적병례채용개량적후외측입로행절개복위내고정치료。근거Lauge-Hansen과관절골절분형，선후외선형18례，선전외선형14례。관찰술후상구유합、골절회복급내고정정황，동시안Phillips과관절평분표준과관절공능진행평고。결과본조수방12～18개월，골절전부유합，유합시간위10～13주。술후절구표천감염1례。근거술후과관절공능근거Phillips과관절평분표준，본조평분위110～150분，평균（140.7±5.5）분；획우20례，량호7례，일반4례，차1례，우량솔위84.3%。결론개량적과관절후외측수술입로불부가충분현로후과골절，동시가겸고외과골절적정복고정，감소수술절구급손상，술야현로청석，치득림상추엄。
Objective To evaluate the clinical outcomes and efficiency the modified posterolateral approach for trimalleolar fractures. Methods From October 2010 to October 2012,32 patients with trimalleolar fractures were treated,including 18 males and 14 females,aged from 20 to 65 years.Fractures were classified with Lange-Hansen classification system:supination-external rotation in 18 cases,and pronation-external rotation in 14 cases. The patients were followed in outpatient clinic way.The fracture healing and ankle function were observed by the X-ray examinations postoperatively.Results All patients got follow-up visit for at least 12 months (from 12 to 18 months,mean 14 months).1 case of all incision was infected Superficially. Postoperative radiograph showed bone union in all the patients.At the final follow-up,according to Phillips ankle scoring system,the score ranged from 110 to 150,with an average of(140.7±5.5). There was excellent in 20 cases,good in 7 cases,fair in 4 cases and poor in 1 case,with an excellent and good rate of 84.3%. Conclusion The modified posterolateral approach can treat the fractures of lateral and posterior malleolar fractures simultaneously,less invasive and has characteristics of good surgical exposure,accurate fracture reduction,and worthwhile for spreading in clinical practice.