中医正骨
中醫正骨
중의정골
The Journal of Traditional Chinese Orthopedics and Traumatology
2015年
11期
13-16
,共4页
鲁建作%林央央%杨杰%董晓敏
魯建作%林央央%楊傑%董曉敏
로건작%림앙앙%양걸%동효민
腓骨%胫骨%踝关节%下胫腓联合%体层摄影术,X 线计算机%皮质骨螺钉
腓骨%脛骨%踝關節%下脛腓聯閤%體層攝影術,X 線計算機%皮質骨螺釘
비골%경골%과관절%하경비연합%체층섭영술,X 선계산궤%피질골라정
fibula%tibia%ankle joint%distal tibiofibular syndesmosis%tomography,X -ray computed%cortical bone screw
目的：探讨皮质骨螺钉内固定对下胫腓联合的影响。方法：回顾性分析32例行皮质骨螺钉内固定术治疗的下胫腓联合分离患者的临床资料，男18例、女14例。年龄28～64岁，中位数43．5岁。左侧14例，右侧18例。按照 Danis －Weber 分型，B 型12例、C 型20例。腓骨骨折合并后踝和内踝（或三角韧带）损伤11例，腓骨骨折合并内踝（或三角韧带）损伤21例。所有患者均摄健、患侧下胫腓骨横断位 CT 片，在 CT 片上测量胫腓骨适合角、胫骨腓切迹与腓骨的相对外移距离和相对后移距离，并对其进行比较分析。结果：患侧胫腓骨适合角、胫骨腓切迹与腓骨的相对外移距离均小于健侧[68．66°±9．28°，79．49°±14．66°，t ＝2．998，P ＝0．025；（5．65±1．79）mm，（7．66±2．05）mm，t ＝2．131，P ＝0．012]，而胫骨腓切迹与腓骨的相对后移距离大于健侧[（4．94±1．49）mm，（1．90±3．34）mm，t ＝14．089，P ＝0．002]。结论：皮质骨螺钉内固定治疗下胫腓联合分离后，患侧下胫腓联合较健侧有向前内侧旋转的趋势。
目的：探討皮質骨螺釘內固定對下脛腓聯閤的影響。方法：迴顧性分析32例行皮質骨螺釘內固定術治療的下脛腓聯閤分離患者的臨床資料，男18例、女14例。年齡28～64歲，中位數43．5歲。左側14例，右側18例。按照 Danis －Weber 分型，B 型12例、C 型20例。腓骨骨摺閤併後踝和內踝（或三角韌帶）損傷11例，腓骨骨摺閤併內踝（或三角韌帶）損傷21例。所有患者均攝健、患側下脛腓骨橫斷位 CT 片，在 CT 片上測量脛腓骨適閤角、脛骨腓切跡與腓骨的相對外移距離和相對後移距離，併對其進行比較分析。結果：患側脛腓骨適閤角、脛骨腓切跡與腓骨的相對外移距離均小于健側[68．66°±9．28°，79．49°±14．66°，t ＝2．998，P ＝0．025；（5．65±1．79）mm，（7．66±2．05）mm，t ＝2．131，P ＝0．012]，而脛骨腓切跡與腓骨的相對後移距離大于健側[（4．94±1．49）mm，（1．90±3．34）mm，t ＝14．089，P ＝0．002]。結論：皮質骨螺釘內固定治療下脛腓聯閤分離後，患側下脛腓聯閤較健側有嚮前內側鏇轉的趨勢。
목적：탐토피질골라정내고정대하경비연합적영향。방법：회고성분석32례행피질골라정내고정술치료적하경비연합분리환자적림상자료，남18례、녀14례。년령28～64세，중위수43．5세。좌측14례，우측18례。안조 Danis －Weber 분형，B 형12례、C 형20례。비골골절합병후과화내과（혹삼각인대）손상11례，비골골절합병내과（혹삼각인대）손상21례。소유환자균섭건、환측하경비골횡단위 CT 편，재 CT 편상측량경비골괄합각、경골비절적여비골적상대외이거리화상대후이거리，병대기진행비교분석。결과：환측경비골괄합각、경골비절적여비골적상대외이거리균소우건측[68．66°±9．28°，79．49°±14．66°，t ＝2．998，P ＝0．025；（5．65±1．79）mm，（7．66±2．05）mm，t ＝2．131，P ＝0．012]，이경골비절적여비골적상대후이거리대우건측[（4．94±1．49）mm，（1．90±3．34）mm，t ＝14．089，P ＝0．002]。결론：피질골라정내고정치료하경비연합분리후，환측하경비연합교건측유향전내측선전적추세。
Objective:To explore the effect of internal fixation with cortical bone screws on the distal tibiofibular syndesmosis. Methods:The clinical records of 32 patients who were treated with cortical bone screws internal fixation for distal tibiofibular syndesmosis were analyzed retrospectively.The patients consisted of 18 males and 14 females,and ranged in age from 28 to 64 years (Median =43.5 yrs).The distal tibiofibular syndesmosis separation located in left leg for 14 cases and right leg for 18 cases.According to the Danis -Weber classification,the injuries belonged to types B(12)and C(20).Fibula fracture combined with posterior malleolus injury and medial malleolus injury or deltoid ligament injury were found in 11 patients,and fibula fracture combined with medial malleolus injury or deltoid ligament injury were found in 21 patients.Bilateral distal tibiofibular transverse CT films were taken in all patients.The tibiofibula congru-ence angle,fibular outward displacement and backward displacement relative to peroneal sinus of tibia were measured on the CT films and were analyzed.Results:The tibiofibula congruence angle and fibular outward displacement relative to peroneal sinus of tibia of affected side were less than those of uninjured side(68.66 +/-9.28 vs 79.49 +/-14.66 degrees,t =2.998,P =0.025;5.65 +/-1.79 vs 7.66 +/-2.05 mm,t =2.131,P =0.012),while fibular backward displacement relative to peroneal sinus of tibia of affected side was greater than that of uninjured side(4.94 +/-1.49 vs 1.90 +/-3.34 mm,t =14.089,P =0.002).Conclusion:After cortical bone screws internal fixa-tion for the treatment of distal tibiofibular syndesmosis separation,there is a trend for anteromedial rotation of distal tibiofibular syndesmosis of affected side compared to uninjured side.
