后踝骨折改良内侧手术入路治疗后踝关节骨折临床分析  

Clinical analysis of modified medial incision approach in the treatment of posterior ankle fracture

作　　者：冷双芝 孙之鹏 宗民 LENG Shuang-zhi SUN Zhi-peng ZONG Min(Department of Hand and Foot Surgery,Jiaozhou Central Hospital of Qingdao City,Shandong Province,Jiaozhou 266300, China Department of Pathogen Vector,Jiaozhou Central Hospital of Qingdao City,Shandong Province,Jiaozhou 266300, China)

机构地区：[1]青岛市胶州中心医院手足外科,山东胶州266300 [2]山东省胶州市疾病控制中心病媒科,山东胶州266300

出　　处：《中国当代医药》2017年第22期75-77,共3页China Modern Medicine

摘　　要：目的探讨改良内侧手术入路治疗后踝关节的临床效果。方法回顾性分析2016年5~10月我科治疗的61例后踝关节骨折患者的临床资料,按手术入路分为改良内侧入路组(n=30)及后外侧入路组(n=31),比较两组的术中情况及术后恢复情况。结果改良内侧入路组的手术时间、术后负重时间、骨折愈合时间短于外侧入路组,术中出血量少于外侧入路组,差异有统计学意义(P<0.05)。改良内侧入路组的术后并发症发生率为3.3%,外侧入路组的并发症发生率为6.5%,两组比较差异无统计学意义(P>0.05)。两组患者术后6个月踝关节功能评价显示,改良内侧入路组的关节功能优良率为90.00%,外侧入路组的关节功能优良率为90.32%,两组比较差异无统计学意义(P>0.05)。结论改良内侧入路治疗后踝关节骨折术中创伤小,恢复快,是较为适宜的手术入路。Objective To explore the clinical efficacy of modified medial incision approach in the treatment of posterior ankle fracture.Methods The clinical data of 61 patients with posterior ankle fracture treated in our department from May to October in 2016 were analyzed retrospectively,the patients were divided into the modified medial approach group（n=30） and the posterolateral approach group（n=31） according to the surgical approach.The intraoperative condition and postoperative recovery of the two groups were compared.Results The operation time,postoperative weight-bearing time and fracture healing time of the modified medial approach group was shorter than that of the lateral approach group,and the amount of bleeding during operation of the modified medial approach group was less than that of the lateral approach group,with significant difference（P〈0.05）.The incidence rate of complication of the modified medial approach group was 3.3%,and the incidence rate of complication of the posterolateral approach group was 6.5%,the difference between the two groups was not statistically significant（P 〉0.05）.The evaluation of ankle function in the two groups at 6 months after operation showed that the excellent and good rate of joint function in the modified medial approach group was 90.00%,and that of the posterolateral approach group was 90.32%,and the difference between the two groups was not statistically significant（P〉0.05）.Conclusion Modified medial approach had less invasive and quicker to recover in the treatment of posterior ankle fracture,and is a better operative approach.

关 键 词：踝关节骨折 改良内侧手术入路 外侧手术入路 关节功能 

分 类 号：R683.42[医药卫生—骨科学]