摘要
目的总结两种不同手术方式治疗Danis-Weber分型(B型)三踝骨折的临床疗效。方法2017年1月~2020年12月收治的Danis-Weber分型(B型)三踝骨折病人67例,依照入院的先后顺序分为两组。对照组35例,采用传统腓骨入路联合内侧入路内固定术,其中下胫腓使用螺钉固定;试验组32例,采用改良的后外侧L形切口联合内侧入路内固定术,下胫腓韧带使用锚钉修复,比较两组的临床疗效。结果试验组手术时间、术中出血量、住院时间、术后骨折愈合率与对照组比较,差异均无统计学意义(P>0.05);试验组术后足踝功能评分(86.78±9.26)高于对照组(79.32±8.23),并发症发生率低于对照组(12.5%vs 25.7%),差异有统计学意义(P<0.05)。结论Danis-Weber分型B型的三踝骨折可以通过改良后外侧L形切口联合内侧入路传统内固定术结合锚定修复下胫腓韧带进行治疗,踝关节功能复原率更高,康复效果好,避免取下胫腓螺钉。
Objective To explore the clinical effects of two different surgical methods in the treatment of Danis-Weber type(B)three ankle fractures.Methods The 67 cases of Danis-Weber type(type B)three-ankle fractures admitted to the hospital from January 2017 to February 2021 were selected as the research objects,and they were divided into two groups according to the order of admission.The 35 cases in the control group used traditional fibular approach combined with medial approach internal fixation,in which the lower tibia and fibula were fixed with screws;the 32 cases in the test group used a modified posterolateral L-shaped incision combined with medial approach internal fixation,and the inferior tibiofibular ligament was used Anchor repair,compare the surgical efficacy of the two groups.Results There were no significant differences in the operation time,intraoperative blood loss,hospital stay,and postoperative fracture healing rate in the experimental group compared with the control group(P>0.05);the postoperative ankle function scores of the experimental group(86.78±9.26)were higher than those in the control group(79.32±8.23).The incidence of postoperative complications was lower than that of the control group,and the difference was statistically significant(12.5%vs 25.7%,P<0.05).Conclusion Danis-Weber type B three ankle fractures can be treated by modified posterolateral L-shaped incision combined with traditional internal fixation combined with medial approach combined with anchoring to repair the tibiofibular ligament.The recovery rate of ankle joint function is higher,the rehabilitation effect is better,and tibiofibular screw removal is avoided.
作者
黄林新
杨绪荣
张忠辉
杨亨利
HUANGLinxin;YANG Xurong;ZHANG Zhonghui(Department of Orthopedics,Jiangle County General Hospital,Fujian Province,Sanming City,Jiangle County 353300,China)
出处
《临床外科杂志》
2021年第12期1168-1170,共3页
Journal of Clinical Surgery
