摘要
目的分析踝关节骨折切开复位内固定后下胫腓联合分离固定和未固定的差异及对踝关节功能、疼痛度的影响。方法选取2018年1月至2020年12月南京市江宁医院收治的106例踝关节骨折合并下胫腓联合分离患者为研究对象,以随机数表法分为两组,A组在踝关节骨折切开复位内固定术后固定下胫腓联合分离,B组未固定下胫腓联合分离,对比两组临床疗效、治疗前后下胫腓重叠距离(lower tibia and fibula overlap distance,TBOL)、下胫腓间隙(tibiofibular space,TBCS)、视觉模拟疼痛(visual analogue scale,VAS)评分、Baird-Jackson踝关节功能评分。结果治疗后,A组优良率为92.45%,B组为90.57%,差异无统计学意义(x^(2)=0.121,P>0.05);A组术后TBOL、TBCS分别为(8.52±1.15)mm、(3.41±0.15)mm,与B组的(8.49±1.13)mm、(3.45±0.13)mm比较,差异无统计学意义(t分别为0.135、1.467,P>0.05);A组术后Baird-Jackson踝关节功能评分为(95.02±1.05)分,与B组的(95.05±1.03)分比较,差异无统计学意义(t=0.000,P>0.05);A组术后VAS评分为(3.12±0.15)分,与B组的(3.09±0.13)分比较,差异无统计学意义(t=1.100,P>0.05)。结论在内、外踝等结构固定、复位效果满意的情况下,下胫腓联合固定与否对踝关节解剖结构、功能的影响不大,应以术中踝关节稳定性结构恢复情况为依据,决定踝关节骨折切开复位内固定后是否进行下胫腓联合分离固定。
Objective To compare the clinical efficacy of distal tibiofibular syndesmosis separation fixation and non fixation after open reduction and internal fixation of ankle fractures.Methods From January 2018 to December 2020,106 patients with ankle fracture combined with lower tibiofibular syndesmosis separation in Nanjing Jiangning hospital were selected as the research objects and randomly divided into two groups.Group A fixed lower tibiofibular syndesmosis separation during open reduction and internal fixation of ankle fracture,and group B did not fix lower tibiofibular syndesmosis separation Lower tibiofibular overlap distance(tbol),tibiofibular space(TBCs),visual analogue scale(VAS)score,Baird Jackson ankle function score before and after treatment.Results After treatment,the excellent and good rate of group A was 92.45%,group B was 90.57%,the difference was not statistically significant(x^(2)=0.121,P>0.05);postoperative TBOL and TBCS in group A were(8.52±1.15)mm,(3.41±0.15)mm,compared with(8.49±1.13)mm and(3.45±0.13)mm in group B,the difference was not statistically significant(t=0.135,1.467,P>0.05);the postoperative Baird-Jackson ankle in group A The functional score was(95.02±1.05)points.Compared with the(95.05±1.03)points of group B,the difference was not statistically significant(t=0.000,P>0.05);the postoperative VAS score of group A was(3.12±0.15)points Compared with the(3.09±0.13)score of group B,the difference was not statistically significant(t=1.100,P>0.05).Conclusion When the internal and external malleolus and other structures are fixed and the effect of reduction is satisfactory,whether the inferior tibiofibular syndesmosis is fixed or not has little effect on the ankle joint anatomy and function.The ankle should be determined based on the stability of the ankle joint during the operation.Whether the joint fracture is separated and fixed after open reduction and internal fixation.
作者
姜于志
张崛
高想
周信
孙福荣
邱昊
Jiang Yuzhi;Zhang Jue;Gao Xiang;Zhou Xin;Sun Furong;Qiu Hao(Department of orthopedics,Nanjing Jiangning hospital,Nanjing 211100,China)
出处
《足踝外科电子杂志》
2021年第4期35-38,共4页
Electronic Journal of Foot and Ankle Surgery
基金
江苏省南京市卫生计划项目(ZK16B34)。
关键词
踝关节骨折
切开复位内固定
下胫腓联合分离
下胫腓间隙
下胫腓重叠距离
ankle fracture
open reduction and internal fixation
the distal tibiofibular syndesmosis
inferior tibiofibular space
the overlapping distance of the lower tibiofibular region
