摘要
目的探讨Wilson法摄片对单纯下胫腓联合分离的诊断以及术中对踝穴关系判定的意义。方法18例患者常规摄踝关节正侧位片 ,再以Wilson法摄片作为标准对照 ,对 16例确诊患者行拉力螺钉内固定术。结果用Wilson法摄片 ,排除 2例过度诊断患者 ,在Wilson法基础上加外旋外展应力 ,确诊 2例漏诊患者。 16例手术患者中 2例术后第 6周踝关节背伸疼痛 ,Wilson法摄片示下胫腓联合间隙较健侧变窄 ,拔除内固定后缓解。 16例患者术后再随访Wilson法摄片 ,均显示下胫腓联合正常。结论Wilson法摄片对诊断单纯下胫腓分离有重要意义 ,必要时加以外旋外展应力则可进一步提高诊断率 ,术中Wilson法摄片可以预防内固定过紧。
ObjectivesTo explore the significance of Wilson position roentgenography (WPR) for diagnosis of simple distal tibiofibular syndesmotic separation(SDTSS) and judge the relation with ankle joint in its operation.MethodsEighteen cases of ankle injuries were examined by routine anterior posterior (A P) and lateral view x ray films and then additional WPR was taken.Sixteen cases of SDTSS were diagnosed and internal fixations were performed with a lag screw for 6 weeks.ResultsOn WPR, two ankles were excluded for no syndesmotic separation ; while diagnosis of other 2 ankles which showed normal syndesmosis in A P view film were confirmed by WPR plus stress of external rotation and abduction.Sixteen operated cases of distal tibiofibular separations were followed up averagely for 1.4 years (6 months to 2 years). At 6th week after operation, movement with painless full range was obtained in 14 ankles; the other 2 ankles had a painful dorsal extension and over tightening syndesmosis was detected by Wilson position x ray film. Their pain was relieved after removal of syndesmotic screw. During the latest follow up, normal syndesmoses were achieved in all operated ankles.ConclusionWPR plays an important role in the diagnosis of SDTSS, If necessary, additional stress of external rotation and abduction can further raise its rate of diagnosis. Over tightening of the ankle syndesmosis in operation would also be avoided by WPR.
出处
《医学临床研究》
CAS
2003年第9期693-694,697,共3页
Journal of Clinical Research
