摘要
目的观察无头双加压螺钉内固定与传统切开复位内固定治疗外伤性踝关节骨折对踝关节功能的改善作用。方法前瞻性纳入2017年1月~2020年3月我院骨科收治的踝关节骨折病人98例,采用随机数字表法分为研究组和对照组,每组各49例。对照组采用传统切开复位内固定治疗,研究组实施无头双加压螺钉内固定治疗。比较两组围术期指标、AOFAS评分及GQOLI-74评分差异。两组均随访1年,对比两组术后并发症发生情况,分析临床疗效的差异。结果研究组治疗优良率为93.88%,对照组为71.43%(P<0.05)。研究组平均手术时间为(40.94±6.72)分钟、术中出血量为(41.77±8.26)ml、骨折愈合时间为(10.72±1.66)周,对照组分别为(57.93±13.18)分钟、(56.28±12.27)ml和(13.76±2.08)周,两组比较差异有统计学意义(P<0.05)。研究组术后12个月屈(28.19±5.23)°、伸(8.89±1.52)°、旋前(19.09±2.69)°、旋后活动度(16.81±2.83)°,对照组分别为(24.87±4.75)°、(7.63±1.67)°、(17.28±2.45)°及(14.13±2.57)°,两组比较差异有统计学意义(P<0.05),研究组各维度生活质量评分分别为(72.55±8.83)分、(73.65±9.12)分、(68.69±7.01)分和(73.18±9.23)分,对照组分别为(65.12±8.17)分、(68.35±8.73)分、(63.12±6.84)分和(67.22±8.74)分,两组比较差异有统计学意义(P<0.05)。研究组术后并发症发生率为2.04%,对照组为16.33%,研究组VAS评分为(0.83±0.23)分,对照组为(2.14±0.71)分,两组比较差异有统计学意义(P<0.05)。结论无头双加压螺钉内固定治疗疗效显著,可有效促进病人骨折愈合,提升踝关节功能和生活质量评分,且术后并发症较少,安全性好。
Objective To explore the effects of headless double compression screws and traditional open reduction and internal fixation on ankle joint function in patients with traumatic ankle fracture.Methods A total of 98 patients who were prospectively included in the study and were admitted to the Department of Orthopedics of our hospital from January 2017 to March 2020.They were divided into a study group and a control group by using the random number table,with 49 cases in each group.The patients in the control group were given the traditional open reduction and internal fixation treatment,while those in the research group were given the headless double compression screw internal fixation treatment.The differences of perioperative indicators,AOFAS score and GQOLI-74 score between the two groups were compared.Both groups were followed up for one year,and the differences in clinical effects were comprehensively analyzed by comparing the occurrence of postoperative complications between the two groups.Results The therapeutic efficacy rate of the study group was 93.88%,which was significantly higher than 71.43%in the control group(P<0.05).The mean operation time[(40.94±6.72)min],intraoperative blood loss[(41.77±8.26)ml]and fracture healing time[(10.72±1.66)weeks]in the study group were significantly lower than those in the control group[(57.93±13.18)min,(56.28±12.27)ml and(13.76±2.08)weeks,P<0.05].The flexion[(28.19±5.23)°],extension[(8.89±1.52)°],pronation(19.09±2.69)and supination range of motion(16.81±2.83)°in the study group 12 months after surgery were greater than those in the control group[(24.87±4.75)°,(7.63±1.67)°,(17.28±2.45)°and(14.13±2.57)°,P<0.05].In addition,the improvement degrees of the scores of the QOL in each dimension in the research group[(72.55±8.83),(73.65±9.12),(68.69±7.01)and(73.18±9.23)]were significantly superior to those of the control group[(65.12±8.17),(68.35±8.73),(63.12±6.84)and(67.22±8.74)](P<0.05).The incidence of postoperative complications in the research gro
作者
冯跨
王雪燕
李大成
张小雪
陈传杰
FENG Kua;WANG Xueyan;LI Dacheng(Department of Rheumatology and Immunology,Afiliated Hospital of Chengde Medical College,Hebei,Chengde 067000,China)
出处
《临床外科杂志》
2023年第2期185-189,共5页
Journal of Clinical Surgery
基金
河北省承德市科技局支撑计划课题(201801A011)。
关键词
无头双加压螺钉内固定
传统切开复位内固定
外伤性
踝关节骨折
踝关节功能
改善作用
headless double compression screw
traditional open reduction and internal fixation
traumatic
ankle fracture
ankle joint function
improving effect
