Knotless TightRope缝合器治疗陈旧性下胫腓联合损伤的疗效  

Clinical efficacy of suture-fixation for old injury of distal tibiofibular syndesmosis treated with Knotless Tight Rope

作　　者：闵晓晖[1] 茅凌洲[2] 丛锐军[2] 

机构地区：[1]上海市同济医院骨科,上海200065 [2]上海市第十人民医院骨科,上海200072

出　　处：《外科研究与新技术》2016年第4期248-251,共4页Surgical Research and New Technique

摘　　要：目的探讨Knotless Tight Rope缝合器治疗陈旧性下胫腓联合损伤伴分离的临床疗效。方法连续52例陈旧性损伤患者接受手术,依次分为试验组和对照组,先进行满意复位。试验组使用Knotless Tight Rope下胫腓联合缝合器固定,对照组采用4.5 mm螺钉固定。记录患者术后的视觉模拟评分法(visual analogue scale,VAS)评分、美国足踝医师协会(American Orthopaedic Foot and Ankle Society,AOFAS)评分、SF-36评分和踝关节活动度,并记录术后伤口感染、内固定断裂及下胫腓联合再分离等并发症。结果本组52例均获随访,平均随访时间(22.3±7.1)个月。踝关节活动度两组间差异无统计学意义;VAS评分、SF-36评分、AOFAS评分术后3和6个月差异无统计学意义;术后22个月差异有统计学意义。两组均无伤口感染,试验组无再次胫腓分离发生,对照组5例内固定断裂后发生胫腓再次分离,组间差异有统计学意义。结论 Knotless Tight Rope下胫腓联合缝合器治疗陈旧性下胫腓联合损伤伴下胫腓分离的中期疗效确切,具有固定效果可靠、不存在内固定断裂和患者可早期负重锻炼等优点。Objective To investigate the clinical efficacy of suture-fixation for old injury of distal tibiofibular syndesmosis treated with Knotless TightRope. Methods Fifty-two consecutive patients undergoing surgery were divided into experiment group and control group. Patients in experiment group received suture-fixation for distal tihiofibular syndesmosis by Knotless TightRope, and those in control group underwent fixation with 4.5 mm screws. The postoperative complications, motion range of ankle-joint, visual analogue scale （VAS） scores, American Orthopaedic Foot and Ankle Society（AOFAS） scores, SF-36 scores were recorded and analyzed. Results All these 52 patients were followed up for an average of （22.3±7.1） months. There was no significant difference in motion range of ankle-joint between two groups. There was no significant difference in VAS scores, SF-36 scores and AOFAS scores between two groups 3 and 6 months after operation, while there were significant differences in these parameters between two groups 22 months after operation, All cases healed without infection. Distal tibiofibular syndesmosis separated in 5 patients after fixation breakage in control group, and no re- separation occurred in experiment group, with significant differences between two groups. Conclusion Knotless TightRopehas has definite mid-term clinical effect for old injury of distal tibiofibular syndesmosis, which ensures reliable fixation and facilitates early exercise with full weight bearing.

关 键 词：下胫腓联合 损伤 修复重建 

分 类 号：R687.3[医药卫生—骨科学]