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外科研究与新技术(中英文) ›› 2026, Vol. 15 ›› Issue (3): 271-274.doi: 10.3969/j.issn.2095-378X.2026.03.016

• 综述 • 上一篇    下一篇

踝关节骨折下胫腓内固定方式选择的研究进展

谷文翰, 钟武   

  1. 深圳市龙岗区第三人民医院骨科,广东 深圳 518115
  • 收稿日期:2026-06-12 出版日期:2026-09-28 发布日期:2026-09-30
  • 通讯作者: 钟 武,电子信箱:huangmengx81@163.com
  • 作者简介:谷文翰(1989—),男,主治医师,从事临床创伤骨科工作

Research advancements on selection of internal fixation methods for ankle joint fractures with lower tibiofibular joint injury

GU Wenhan, ZHONG Wu   

  1. Department of Orthopedics, Third People’s Hospital of Longgang District, Shenzhen 518115, Guangdong, China
  • Received:2026-06-12 Online:2026-09-28 Published:2026-09-30

摘要: 踝关节骨折是骨科常见关节内骨折类型,常伴有下胫腓联合损伤,其固定方式的选择将直接影响骨折愈合质量和关节功能重建。目前临床关于下胫腓联合损伤的内固定方式主要分为刚性内固定和弹性内固定两大类,其中刚性内固定作为绝对坚强固定,虽具有显著的刚性稳定优势,但完全阻断下胫腓联合的生理性活动,还存在断钉隐患、二次取出等局限。弹性固定方式,以纽扣-缝线固定系统、钛缆环扎固定、高强度缝线+Nice结固定为代表,能有效保留生理性微动,降低应力遮挡,成为近年临床应用的主流方向。既往文献多局限于单一术式的横向比对,本文将系统梳理各类内固定的优劣、适应证变迁以及最新研究争议,为临床的踝关节骨折下胫腓内固定方式选择提供循证依据。

关键词: 踝关节骨折, 下胫腓联合损伤, 内固定, 刚性固定, 弹性固定

Abstract: Ankle joint fractures are a common type of intra-articular fractures in orthopedics, often accompanied by lower tibiofibular joint injury. The choice of fixation method directly affects the quality of fracture healing and joint function reconstruction. Currently, clinical internal fixation methods for lower tibiofibular joint injury mainly fall into two categories: rigid internal fixation and elastic internal fixation. Rigid internal fixation, as an absolutely rigid fixation, possesses significant advantages in terms of rigid stability, but it completely blocks the physiological movement of the lower tibiofibular joint and has limitations such as the risk of screw breakage and secondary removal. Elastic fixation methods, represented by the button-suture fixation system, titanium cable looping fixation, and high-strength suture + Nice knot fixation, can effectively preserve physiological micromotion and reduce stress shielding, becoming the mainstream direction in clinical applications in recent years. Previous literature has mostly been limited to horizontal comparisons of single surgical techniques. This article systematically reviewed the advantages and disadvantages of various internal fixation methods, changes in indications, and the latest research controversies, providing evidence-based guidance for the selection of internal fixation methods for ankle joint fractures with lower tibiofibular joint injury in clinical practice.

Key words: Ankle joint fracture, Lower tibiofibular joint injury, Internal fixation, Rigid fixation, Elastic fixation

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