空心钉与钢板治疗后踝骨折临床疗效对比分析  

A Clinical Comparative Study of Percutaneous Cannulated Screw Versus Plate Fixation for Posterior Ankle Fractures

作　　者：雷磊[1] 杨铁毅[2] 王治[2] 郑士伟[2] 刘树义[2] 刘粤[2] 

机构地区：[1]宁夏医科大学,银川750004 [2]上海市浦东新区公利医院骨科,上海200135

出　　处：《宁夏医科大学学报》2012年第8期783-785,789,封3,共5页Journal of Ningxia Medical University

摘　　要：目的比较运用空心钉与钢板内固定治疗后踝骨折的疗效。方法回顾分析我院2006年1月至2012年3月间应用空心钉内固定术(48例)及钢板内固定术(36例)治疗后踝骨折患者84例(文哲后踝骨折分型Ⅲ型60例,Ⅳ型24例)资料,比较两种治疗方法关节功能(术后1年AOFAS评分)、骨折愈合时间、完全负重时间及相关并发症等差异。结果所有患者均获得平均16.2个月(12～23个月)随访。空心钉内固定组术后1年AOFAS评分63～98分,平均85.4分;X线愈合时间平均为9.1周(8～11周),完全负重时间平均为10.8周(9～12周),11例发生并发症。钢板内固定组术后1年AOFAS评分65～97分,平均89.6分;X线愈合时间平均为8.8周(8～10周),完全负重时间平均为10.1周(9～12周),6例发生并发症。两组间AOFAS评分比较差异具有统计学意义(P<0.05),余指标两组差异均无统计学意义(P>0.05)。结论对于复杂后踝骨折(Ⅲ、Ⅳ型)的治疗,钢板固定可以提供比空心钉更好的治疗结果,使踝关节功能最大限度地得到早期恢复。Objective To compare the functional and radiographic outcomes of percutaneous cannulated screw and plate fixation in treatment of patients with posterior ankle fractures.Methods From January 2006 to March 2012,84 patients with posterior ankle fractures were treated with percutaneous cannulated screw or plate fixation.Their functional and radiographic outcomes were reviewed to compare the differences in bone union time,full weight-bearing time,American orthopaedic foot and ankle society(AOFAS) scores and complications.Results 84 cases had complete follow-up records and a mean follow-up of 16.2 months(range,12 to 23 months).11 complications occurred in the cannulated screw fixation group.The mean full weight-bearing time and radiographic bone union time were 10.8 and 9.1 weeks respectively in the cannulated screw fixation group which had a mean AOFAS score of 85.4 points.Six complications were found in the plating group.The mean full weight-bearing time and radiographic bone union time were 10.1 and 8.8 weeks respectively in the plating group which had a mean AOFAS score of 89.6 points.There were no significant differences between the two groups except AOFAS score aspect.Conclusion For big side or comminuted posterior ankle fractures,the plate fixation is a good choice for patient of a necessary condition of ankle joint early functional exercise.

关 键 词：后踝骨折 钢板内固定 空心钉内固定 关节功能 

分 类 号：R687.3[医药卫生—骨科学]