摘要
目的 探讨锁定钢板联合皮质螺钉内固定治疗踝关节骨折伴下胫腓分离对踝关节功能及生活质量的影响。方法 2020年5月~2021年12月我院收治的踝关节骨折伴下胫腓分离病人120例,依据随机数字表法将其分为对照组和观察组,每组各60例。对照组采用单纯皮质螺钉固定治疗,观察组采用锁定钢板联合皮质螺钉内固定治疗。术前、术后6个月对两组恢复功能对比,比较X线片、手术时间、愈合时间、术中失血量,术后并发症,生活能力(BI)评估两组病人生活能力。依照美国足踝外科协会评分系统评估病人踝关节功能。结果 术前两组病人关节功能无差异(P>0.05),术后,对照组最远行走评分(15.89±0.85)分、足部对线评分(15.06±0.71)分、疼痛反应评分(29.03±4.48)分、地面行走评分(15.65±0.59)分;观察组分别为(16.19±0.87)分、(15.29±0.76)分、(31.24±4.55)分、(15.96±0.68)分。观察组最远行走、足部对线、疼痛反应、地面步行高于对照组,差异有统计学意义(P<0.05)。与对照组比较,观察组术中出血量少,愈合时间较短,差异有统计学意义(P<0.05)。术前两组BI指数比较,差异无统计学意义(P>0.05);观察组术后BI指数高于对照组,两组比较,差异有统计学意义(P<0.05)。两组并发症总发生率比较无差异(P>0.05)。结论 锁定钢板联合皮质螺钉内固定技术治疗踝关节骨折合并下胫腓分离,可改善踝关节功能,降低术中出血量,促进愈合,提高生活能力。
Objective To investigate the effect of locking plate combined with cortical screw internal fixation on ankle function and quality of life in patients with ankle fracture with tibiofibular separation.Methods A total of 120 patients with ankle fracture and distal tibiofibular separation treated in our hospital from May 2020 to December 2021 were selected and divided into control group and observation group according to random number table method,with 60 patients/group.The control group was treated with cortical screw fixation alone,and the observation group was treated with locking plate combined with cortical screw internal fixation.Before surgery and 6 months after surgery,the recovery function of the two groups was compared.X-ray,operation duration,healing time,intraoperative blood loss,postoperative complications were compared,and the living ability of the two groups of patients was evaluated.Results Before treatment,there was no difference in joint function between the two groups(P>0.05).After treatment,the longest walking of the control group(15.89±0.85),foot alignment(15.06±0.71),pain response(29.03±4.48) and ground walking(15.65±0.59).The longest walking distance(16.19±0.87),foot alignment(15.29±0.76),pain response(31.24±4.55) and ground walking(15.96±0.68) in the observation group,which were higher than those in control group(P<0.05).Compared with the control group,the intraoperative blood loss and healing time in the observation group were lower(P<0.05).BI index of the two groups before treatment had no difference(P> 0.05);After treatment,BI index of observation group was higher than that of control group(P<0.05).There was no difference in the total complication rate between the two groups(P>0.05).Conclusion Locking plate combined with cortical screw internal fixation has a good therapeutic effect on improving ankle function,reducing intraoperative blood loss,promoting healing and improving behavioral ability in the treatment of ankle fracture combined with hypotibiofibular syndesmosis injury.
作者
韦志坤
王旭东
杨金杰
牛朋彦
邵菲
任少海
WEI Zhikun;WANG Xudong;YANG Jinjie;NIU Pengyan;SHAO Fei;REN Shaohai(Department of Orthopedics,Handan First Hospital,Hebei,Handan 056000,China)
出处
《临床外科杂志》
2024年第1期71-74,共4页
Journal of Clinical Surgery
基金
河北省邯郸市科技计划项目(1723208066-11)。
关键词
踝关节骨折
下胫腓分离
锁定钢板
皮质螺钉内固定
踝关节功能
ankle fracture
inferior tibiofibular separation
locking plate
cortical screw internal fixation
ankle function
