摘要
目的比较观察空心拉力螺钉与后侧支撑钢板治疗后踝骨折(均为三踝涉及后踝)的临床疗效。方法回顾分析该院2013年6月-2018年6月采用空心拉力螺钉(36例)及后外侧支撑钢板(12例)治疗的48例后踝骨折患者的临床资料,采用Kellgren标准评估术后出现创伤性关节炎的情况,采用Olerud-Molander评分及AOFAS评分评估患者术后患者的临床疗效。结果空心拉力螺钉组平均随访时间34.6月,后侧支撑钢板组平均随访时间为31.4月。后踝骨折块占关节面(24.9±7.4 vs 25.3±5.9)%、平均术前等待时间(5.5±4.1 vs 5.6±3.9)d、平均手术时间(83.1±9.9 vs 84.6±8.4)min、手术平均出血量(321.23±20.14 vs 324.75±38.14)mL随访时间(34.6±12.7 vs 31.4±16.7)月等均差异无统计学意义(t=0.441、0.170、0.074、0.412、0.470、0.741,P>0.05)。空心拉力螺旋钉组与后侧支撑钢板组男性患者(58.3%vs 29.4%)、高能量损伤患者(77.8%vs 83.3%)均差异无统计学意义(χ^2=1.007、0.000,P=0.316、1.000>0.05)。两组严重创伤性关节患者(3例vs 1例)以及优良率(27.77%vs 16.66%)差异无统计学意义(χ^2=0.000、0.148,P=1.000、0.700>0.05)。两组Olerud-Molander分(78.1±11.0 vs 79.6±12.3)分及AOFAS评分(78.3±10.1 vs 80.5±12.5)分,差异无统计学意义(t=0.397、0.616,P=0.693、0.541>0.05)。结论对于三踝骨折中后踝骨折,采用后外侧入路空心钉与支撑钢板固定均能得到满意的疗效,两者在影像学评估及临床疗效均无差别。
Objective To compare and observe the clinical efficacy of hollow lag screw and posterior support plate in the treatment of posterior malleolus fractures(both three ankles involving posterior ankle).Methods A retrospective analysis of the clinical data of 48 patients with posterior malleolus fractures treated with hollow lag screws(36 cases)and posterolateral support plates(12 cases)in the hospital from June 2013 to June 2018,and Kellgren criteria was used to evaluate postoperative emergence In the case of traumatic arthritis,Olerud-Molander score and AOFAS score were used to evaluate the clinical efficacy of patients after surgery.Results The average follow-up time of the hollow lag screw group was 34.6 months,and the average follow-up time of the posterior support plate group was 31.4 months.Posterior malleolus fractures occupy the articular surface(24.9±7.4 vs 25.3±5.9)%,the average preoperative waiting time(5.5±4.1 vs 5.6±3.9)d,the average operation time(83.1±9.9 vs 84.6±8.4)min,the arerage blood loss(321.23±20.14 vs 324.75±38.14)mL,and the follow-up time(34.6±12.7 vs 31.4±16.7)points The equal mean difference was not statistically significant(t=0.441,0.170,0.074,0.412,0.470,0.741,P>0.05).There was no statistically significant difference between male patients(58.3%vs29.4%)and patients with high energy injury(77.8%vs 83.3%)between the hollow tension screw screw group and the posterior support plate group(χ^2=1.007,0.000,P=0.316,1.000>0.05).There was no statistically significant difference between the two groups of patients with severely traumatic joints(3 cases vs 1 case)and the excellent and good rate(27.77%vs 16.66%)(χ^2=0.000,0.148,P=1.000,0.700>0.05).There was no significant difference between the two groups of Olerud-Molander score(78.1±11.0 vs 79.6±12.3)points and AOFAS score(78.3±10.1 vs 80.5±12.5)points(t=0.397,0.616,P=0.693,0.541>0.05).Conclusion For the posterior malleolus fracture of the three malleolus fracture,the posterolateral approach can be used to fix the hollow nail and the su
作者
汤志兵
王振
周耀东
刘进炼
TANG Zhi-bing;WANG Zhen;ZHOU Yao-dong;LIU Jin-lian(Department of Orthopedics,Suzhou Kowloon Hospital,Shanghai Jiaotong University School of Medicine,Suzhou,Jiangsu Province,215028 China)
出处
《中外医疗》
2020年第31期18-21,共4页
China & Foreign Medical Treatment
基金
苏州市课题(SYS201511)。
关键词
后踝骨折
固定
空心钉
钢板
Fracture of posterior malleolus
Fixation
Cannulated nail
Plate
