摘要
目的探讨钉板系统与常规螺钉联合接骨板内固定治疗踝部骨折对促进患者快速临床康复的意义。方法选择新鲜踝部骨折患者共86例,其中男性48例,女性38例;年龄22~66岁,平均年龄43.3岁;随机分为对照组和观察组,各43例。其中对照组男性25例,女性18例;年龄25~66岁,平均年龄43.5岁。观察组男性23例,女性20例;年龄22~65岁,平均年龄43.1岁。由同一组手术和护理团队完成,对照组患者接受螺钉和接骨板内固定,观察组则应用钉板系统。比较两组平均手术时间、术中出血量和围手术期并发症发生率。根据视觉模拟量表(VAS)评分比较术后1 d、3 d和7 d的疼痛程度,早期完全负重下地锻炼时间。常规术后随访,比较1个月和3个月踝关节功能美国矫形外科足踝协会(AOFAS)踝一后足评分和并发症情况。结果观察组手术时间、围手术期并发症发生率较对照组降低[(45.6±9.5)min vs(65.3±12.4)min,4.7%vs 18.6%],差异有统计学意义(t=15.326,P=0.000<0.01;χ^2=4.074,P=0.044<0.05);但两组术中出血量差异无统计学意义[(56.2±7.5)mL vs(59.8±9.3)mL;t=0.532,P=0.426>0.05]。观察组术后1 d、3 d和7 d的疼痛VAS评分显著低于对照组(t=3.562、3.754、3.895,P<0.05);观察组较对照组完全负重活动时间缩短[(2.6±0.4)d vs(4.4±0.6)d;t=4.523,P<0.05]。随访两组1个月和3个月AOFAS踝-后足评分、优良率和并发症发生率比较[1个月,(82.3±9.6)分vs(80.8±7.6)分,83.7%vs 79.1%;3个月,(91.3±8.5)分vs(90.7±9.3)分,93.0%vs 90.7%;4.7%vs 9.3%],差异无统计学意义(P>0.05)。结论钉板系统与常规螺钉联合接骨板内固定治疗踝部骨折均有较好的安全性和有效性,钉板系统可促进早期快速临床康复,有较好的推广应用价值。
Objective To compare nail-plate system and conventional screw combined with bone-plate internal fixation treatment for promoting rapid clinical rehabilitation in patients with ankle fracture.Methods A total of 86 patients with fresh ankle fracture from were enrolled,which included 48 males and 38 females,aged 22-66 years old with mean age of 43.3 years old.All of them were randomly divided into control group(n=43,25 males and 18 females,aged 25-66 years old with mean age of 43.5 years old)and observation group(n=43,23 males and 20 females,aged 22-65 years old with mean age of 43.1 years old).With the same operation and nursing team,control group received screws combined with bone-plate internal fixation,and observation group performed with nail-plate system.The mean of operation time,intraoperative blood loss and perioperative complication rate were compared between 2 groups.According to visual analog scale(VAS)score,the pain degrees at 1-day,3-day,and 7-day post operation and early full weight-bearing time of 2 groups were compared.In follow-up,the American Society of Orthopaedic Foot and Ankle Association(AOFAS)scores and complications at 1-month and 3-month were compared between 2 groups.Results The operation time and perioperative complications of observation group were statistically significantly lower than those of control group[(45.6±9.5)minutes vs(65.3±12.4)minutes,4.7%vs 18.6%;t=15.326,P=0.000<0.01;χ^2=4.074,P=0.044<0.05].There was no significant difference in intraoperative blood loss between 2 groups[(56.2±7.5)m L vs(59.8±9.3)mL;t=0.532,P=0.426>0.05].The VAS scores of observation group at 1-day,3-day and 7-day after operation were significantly lower than those of control group(t=3.562,3.754,3.895,P<0.05);The full weight-bearing time of observation group was shorter than that of control group[(2.6±0.4)days vs(4.4±0.6)days;t=4.523,P<0.05].The AOFAS scores,excellent rate and complication rate at 1 month and 3 months after operation had no significant difference between 2 groups[1-month,(82.3±9.6)
作者
黄凯
陈安富
段延辑
HUANG Kai;CHEN An-fu;DUAN Yan-ji(Department of Orthopedics,The First People's Hospital of Neijiang,Neijiang 641000,Sichuan,China)
出处
《生物医学工程与临床》
CAS
2020年第1期65-69,共5页
Biomedical Engineering and Clinical Medicine
关键词
钉板系统
内固定
踝部骨折
临床康复
nail-plate system
internal fixation
ankle fracture
rapid clinical rehabilitation
