摘要
目的探讨对踝关节骨折合并下胫腓联合韧带损伤患者采用外固定治疗与内固定治疗的临床效果差异。方法选择江苏省丹阳市第三人民医院2015年1月—2020年6月收治的踝关节骨折合并下胫腓联合韧带损伤患者50例为研究对象。按照随机数表法分为对照组(石膏外固定治疗,n=25)与试验组(采用内固定术治疗,n=25)。比较两组手术治疗优良率、康复相关指标(骨折愈合时间、二次手术率)、关节功能(采用踝关节Kofoed评分评价)、生活能力(采用日常生活活动能力(activities of daily living,ADL)评分评价)及术后并发症(包括骨折愈合不良、感染、活动障碍等)发生率。结果试验组治疗优良率为100.00%(25/25),高于对照组76.00%(19/25),差异有统计学意义(x^(2)=6.735,P=0.030)。试验组骨折愈合时间、二次手术率分别为(12.51±1.40)周、0.00%(0/25),均小于对照组(14.26±1.68)周、24.00%(6/25),差异有统计学意义(P<0.05)。试验组术后Kofoed评分、ADL评分分别为(84.37±5.28)分、(81.76±11.30)分,高于对照组(78.46±4.55)分、(73.20±10.38)分,差异有统计学意义(t分别为4.240、2.789,P<0.05)。试验组并发症发生率为8.00%(2/25),低于对照组32.00%(8/25),差异有统计学意义(x^(2)=4.500,P=0.034)。结论对踝关节骨折合并下胫腓联合韧带损伤患者采用内固定术治疗疗效优于外固定治疗,患者术后恢复快,有利于改善患者的关节功能及自理能力,且并发症风险小,值得推广。
Objective To investigate the difference of clinical effect between external fixation and internal fixation in patients with ankle fracture combined with lower tibiofibular ligament injury.Methods 50 patients with ankle fracture combined with distal tibiofibular ligament injury admitted to the third people’s Hospital of Danyang City from January 2015 to June 2020 were selected as the research objects.According to the random number table method,they were divided into control group(plaster external fixation,n=25)and experimental group(internal fixation,n=25).The excellent and good rate of surgical treatment,rehabilitation related indicators(fracture healing time,secondary operation rate),joint function(evaluated by ankle kofoed score),living ability(evaluated by ADL score)and the incidence of postoperative complications(including poor fracture healing,infection,movement disorders,etc.)were compared between the two groups.Results The excellent and good rate of the experimental group was 100.00%(25/25),which was higher than 76.00%(19/25)of the control group,and the difference was statistically significant(x^(2)=6.735,P=0.030).The fracture healing time and secondary operation rate of the experimental group were(12.51±1.40)weeks and 0.00%(0/25),respectively,which were smaller than those of the control group[(14.26±1.68)weeks and 24.00%(6/25)](t/x^(2)=4.001,6.735,P<0.05).Postoperative Kofoed score and ADL score in the experimental group were(84.37±5.28)points and(81.76±11.30)points,respectively,which were higher than those in the control group[(78.46±4.55)points、(73.20±10.38)points](T=4.240,2.789,P<0.05).The complication rate of the experimental group was 8.00%(2/25),lower than that of the control group[32.00%(8/25),x^(2)=4.500,P=0.034].Conclusion The curative effect of internal fixation is better than external fixation in the treatment of ankle fracture combined with lower tibiofibular ligament injury.The patients recover quickly after surgery,which is beneficial to improve the joint function and self-care abi
作者
刘杨
文立臣
尹豪
王岩朋
篮传玺
Liu Yang;Wen Lichen;Yin Hao;Wang Yanpeng;Lan Chuanxi(Department of orthopedics,the third people's Hospital of Danyang City,Jiangsu Province,Zhengjiang 212300,China)
出处
《足踝外科电子杂志》
2020年第4期22-25,36,共5页
Electronic Journal of Foot and Ankle Surgery
基金
江苏省卫生计划项目(NO.JH201421)。
关键词
踝关节骨折
外固定
骨铆钉
内固定
韧带损伤
并发症
ankle fracture
external fixation
bone rivet
internal fixation
ligament injury
complications
