摘要
目的比较抗滑钢板固定和空心钉固定对伴后踝骨折踝关节骨折患者疗效及安全性。方法回顾性分析将2018年1月至2019年1月上海市第八人民医院收治的64例伴后踝骨折踝关节骨折患者作为研究对象,根据手术方法不同将患者分为两组:钢板组和空心钉组,每组各32例。钢板组患者采用抗滑钢板固定后踝骨折块治疗,空心钉组患者采用空心钉固定后踝骨折块治疗。术后对患者观察随访6个月,对比两组患者的踝与后足功能评分(AOFAS)、骨折愈合时间、术后6个月踝关节负重状态下的疼痛视觉模拟评分(VAS)以及并发症的发生率。结果治疗前及治疗后2周,钢板组患者的AOFAS评分分别为(60.42±3.9)分、(74.71±5.8)分,与空心钉组的(61.05±4.3)分、(72.66±5.2)分比较,差异均无统计学意义(P>0.05);治疗后6个月,钢板组患者的AOFAS评分为(85.24±3.11)分,显著优于空心钉组的(74.13±4.59)分,差异具有统计学意义(P<0.05)。钢板组患者的骨折愈合时间为(13.1±3.5)周,与空心钉组的(12.8±3.3)周相比,差异无统计学意义(P>0.05)。钢板组患者治疗前VAS评分为(6.7±0.3)分,与空心钉组的(6.6±0.4)分相比,差异无统计学意义(P>0.05);治疗后6个月,钢板组患者的VAS评分为(1.6±0.2)分,显著优于空心钉组的(3.5±0.4)分,差异有统计学意义(P<0.05)。钢板组并发症发生率为6.25%,显著优于空心钉组的28.13%,差异有统计学意义(P<0.05)。结论采用抗滑钢板固定疗效更佳且具有方便、利于患者进行早期功能锻炼等优点,值得在临床中推广使用。
Objective To compare the effect and safety of locking plate fixation and intramedullary nail fixation in ankle fracture patients with posterior malleolar fracture.Methods 64 ankle fracture patients with posterior malleolar fracture admitted to Shanghai Eighth People's Hospital from January 2018 to January 2019 were retrospectively selected as study subjects.The patients were divided into two groups according to their different surgical methods:locking plate fixation group and the intramedullary nail fixation group,with 32 cases in each group.Patients in the locking plate fixation group were treated with locking plate for fixing posterior malleolar fracture block,and patients in the intramedullary nail fixation group were treated with intramedullary nail for fixing posterior malleolar fracture block.The patients were followed up for 6 months after operation,the AOFAS(American orthopedic foot and ankle society)scores,fracture healing time,of the two groups,the VAS(visual?Analogue?Scale/Score)of the ankle joint at weight-bearing state at 6 months after operation and the complication rate of the two groups were compared.Results Before treatment and 2 weeks after treatment,the AOFAS scores of patients in the locking plate fixation group were(60.42±3.9)points and(74.71±5.8)points,compared with(61.05±4.3)points and(72.66±5.2)points in the intramedullary nail fixation group.The difference was not statistically significant(P>0.05).At 6 months after treatment,the AOFAS score of patients in the locking plate fixation was(85.24±3.11)points,which was significantly better than that of the intramedullary nail fixation group[(74.13±4.59)points],and the difference was statistically significant(P<0.05).The fracture healing time of patients in the locking plate fixation was(13.1±3.5)weeks,which was not significantly different from that in the intramedullary nail fixation group[(12.8±3.3)weeks](P>0.05).The VAS of patients in the locking plate fixation group before treatment was(6.7±0.3)points,and in the intramedullary nail
作者
沈骏
高田田
杨杰
SHEN Jun;Gao Tian-tian;YANG Jie(Department of Orthopedics,Shangai NO.8 People's Hospital,Shanghai 200233,China.)
出处
《临床和实验医学杂志》
2020年第12期1328-1331,共4页
Journal of Clinical and Experimental Medicine
基金
上海市科学技术委员会支持项目(编号:18dz2300500)。
关键词
伴后踝骨折踝关节骨折
抗滑钢板固定
空心钉固定
Ankle fracture with posterior malleolus fracture
Locking plate fixation
Intramedullary nail fixation
