摘要
目的:探讨手术治疗踝关节骨折合并三角韧带完全断裂的近期临床疗效。方法:回顾性分析2016年1月至2019年3月采用骨折固定联合三角韧带修复手术治疗的踝关节骨折合并三角韧带完全断裂的中青年患者21例,其中男16例,女5例;年龄21~52(38.6±7.3)岁;受伤至手术时间1~7(3.8±1.5)d。观察患者骨折愈合时间及并发症情况,比较手术前后内踝间隙变化,并于术后18个月采用美国足与踝关节协会(American Orthopaedic Foot and Ankle Society,AOFAS)评分进行功能评价。结果:21例患者均获得随访,时间18~26(21.7±1.2)个月。切口均Ⅰ期愈合,骨性愈合时间8~12(9.5±1.6)周。术后未出现感染、内固定失败、神经损伤等并发症。术后内踝间隙(2.69±0.25)mm较术前(5.83±0.32)mm明显改善(P<0.001)。术后18个月AOFAS评分(91.43±4.14)分,其中优14例,良6例,可1例。结论:在坚强固定骨折的同时,修复三角韧带能帮助中青年患者恢复踝关节内侧解剖结构,可以取得良好的近期临床疗效。
Objective:To explore short-term clinical effect of surgical treatment for ankle fracture with complete rupture of deltoid ligament in young and middle-aged patients.Methods:From January 2016 to March 2019,21 young and middle-aged patients with ankle joint fracture and complete rupture of the deltoid ligament were treated with internal fixation and repair of the medial deltoid ligament,including 16 males and 5 females,aged from 21 to 52 years old with an average of(38.6±7.3)years old,the time from injury to operation ranged from 1 to 7 days with an average of(3.8±1.5)days.Fracture healing time and complications were observed,changes of medial malleolus clearance before and after operation were compared,American Orthopaedic Foot and Ankle Society(AOFAS)score was used to evaluate function of ankle joint at 18 months after operation.Results:Twenty-one patients were followed up from 18 to 26 months with an average of(21.7±1.2)months.The incisions were healed at stageⅠ,and fracture healing time ranged from 8 to 12 weeks with an average of(9.5±1.6)weeks.No wound infection,failure of internal fixation,and nerve injury occurred.Medial malleoius space decreased from(5.83±0.32)mm before operation to(2.69±0.25)mm after operation.Postoperative AOFAS score at 18 months was 91.43±4.14,14 patients got excellent results,6 good and 1 fair.Conclusion:On the basis of stable fixation of fracture,repair of deltoid ligament could help restoring the medial anatomy of ankle joint in young and middle-aged patients,and could achieve good short-term clinical effect.
作者
常小波
王勤业
习洪波
陈圣
CHANG Xiao-bo;WANG Qin-ye;XI Hong-bo;CHEN Sheng(Department of Orthopaedics,Nanxiang Hospital of Jiading District,Shanghai 201802,China)
出处
《中国骨伤》
CAS
CSCD
2020年第7期655-658,共4页
China Journal of Orthopaedics and Traumatology
关键词
韧带
踝损伤
骨折固定术
内
Ligament
Ankle injuries
Fracture fixation,internal
