踝关节骨折伴急性三角韧带损伤诊疗现状概述

doi:10.3877/cma.j.issn.1674-134X.2019.03.017

踝关节骨折临床上发生率很高，常需手术治疗。当伴随三角韧带损伤时，则多见于旋前以及部分旋后外旋Ⅳ度的踝关节骨折。临床上此类诊断常较困难，手术修复的时机及方法目前也无统一标准。本文主要综述了近年来"踝关节骨折伴三角韧带损伤"诊疗的研究进展。三角韧带损伤的诊断常需综合各项辅助检查及症状体征来判断，其中以应力试验及磁共振检查最为重要；术中骨折复位固定后发现踝关节不稳或三角韧带嵌顿阻止复位，则建议术中探查修复，修复的方法众多，目前以带线锚钉重建三角韧带为主。

关键词: 踝关节骨折, 侧副韧带, 诊断, 治疗

Incidence rate of ankle fracture is very high in clinic, and this kind of fracture often needs surgical treatment.When it accompanies by the deltoid ligament injury, it is more common in pronation rotation and part of the supination external rotation of Ⅳ degree ankle fracture. Clinical diagnosis of this kind of fracture is very difficult, and there is no uniform standard for the timing and methods of surgical repair. This paper reviewed the recent progress in the diagnosis and treatment of ankle fracture with deltoid ligament injury. It is concluded that the diagnosis of deltoid ligament injury often needs to be judged by a combination of various auxiliary examinations and signs and symptoms, among which stress test and magnetic resonance examination are the most important.After intraoperative fracture reduction and fixation, it is found that ankle instability or incarceration of the triangular ligament prevented reduction. Therefore, intraoperative exploration and repair are recommended. There are many methods for repair, and the reconstruction of the deltoid ligament with wire anchors is the main method at present.

Key words: Ankle fractures, Collateral ligaments, Diagnosis, Therapeutics

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Summary of diagnosis and treatment of ankle fracture with acute deltoid ligament injury

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Summary of diagnosis and treatment of ankle fracture with acute deltoid ligament injury