医学护理专业毕业论文.doc

摘 要：回顾分析手术复位螺钉内固定治疗踝关节旋后—外旋Ⅳ度损伤的治疗疗效。方法? 自1998年5月～2003年3月，共手术治疗37例踝关节旋后—外旋Ⅳ度损伤，获随访33例，随访时间12～40个月，平均18个月，男21例，女12例；年龄17～68岁，平均38岁。左侧18例，右侧15例，均为单侧。其中内踝骨折31例，行拉力螺钉内固定，2例无内踝骨折为单纯三角韧带撕裂，作韧带修补。后踝骨折27例，其中17例作拉力螺钉内固定，10例因骨折块移位＜1mm未作复位固定，6例无后踝骨折。33例外踝骨折，用2枚皮质骨螺钉过骨折线固定。共有4例行下胫腓联合固定，用1枚拉力螺钉过3层皮质固定。所有病例术后石膏托辅助固定4～6周。结果? 用Mazur踝关节症状与功能评分系统评判，优23例，良7例，可3例，无差。优良率91%。结论? 手术复位螺钉内固定治疗踝关节旋后—外旋Ⅳ度损伤具有优良疗效。踝关节；骨折；内固定 wed up 33 cases, follow-up time 12 ~ 40 months, an average of 18 months, male, female 12 cases of 21 cases; Aged 17 ~ 68 years old, average 38 years old. The left 18 cases, right in 15 cases, are unilateral. Among them, do NaHuai fracture 31 cases of internal fixation, tension screw 2 cases without NaHuai fracture as merely triangle, ligament repair a torn ligament. An ankle fractures after 27 cases, 17 cases as tension screw internal fixation, 10 patients with fracture displacement 1mm block not reset fixed, 6 patients without the ankle fractures. 33 exception, with an ankle fractures had 2 pieces cortical bone fractures fixed screw thread. There are four routine anteroinferior tibiofibular phil joint fixed, using 1 commemorative tension screw three layer cortical fixed. All cases postoperative cast auxiliary fixed 4 ~ 6 weeks. Results Mazur ankle with symptoms and functional score system evaluation, excellent in 23 cases, good in 7 cases, 3 cases, no difference can be. Dykes 91%. Conclusions surgical reset screw internal fixation for ankle spin Ⅳ degrees after the spin -- damage has good curative effect. Keywords : ankle; Fracture; Internal fixation  目 录 一、资料与方法 ……………………………………………………………………………1 （一）一般资料 ……………………………………………………………………………1? （二）手术方法 ……………………………………………………………………………1 （三）疗效评价 ……………………………………………………………………………2 二、结果 ……………………………………………………………………………………2 （一）手术疗效评定并发症 （一）内侧结构的修复 ……………………………………………………………………2? （二）外踝的固定 …………………………………………………………………………3? （三）下胫腓联合的固定 …………………………………………………………………3 （四）后踝的固定 …………………………………………………………………………4 五、参考文献 ………………………………………………………………………………5 　踝关节是全身负