后前方置入空心钉治疗后踝骨折患者的疗效观察及术后中、远期随访研究  

Curative effect observation and postoperative mid-term and long-term follow-up study of posteroanterior cannulated screw fixation in the treatment of fractures of posterior malleolus

作　　者：白绍元[1] Bai Shaoyuan(Hands and Feet Microsurgery, Sanmenxia Central Hospital, Sanmenxia 472000, Chin)

机构地区：[1]三门峡市中心医院手足显微外科,472000

出　　处：《国际医药卫生导报》2018年第5期670-673,共4页International Medicine and Health Guidance News

摘　　要：目的探究后前方置人空心钉治疗后踝骨折患者的疗效。方法选取2012年2月至2014年8月本院82例后踝骨折患者，依据手术方案不同分组，每组41例。两组均行空心钉内固定术治疗，对照组由前向后置入空心钉，实验组由后向前置入空心钉。术后随访3年，观察记录两组骨折愈合、完全负重时间、并发症发生、骨折移位及关节功能（AOFAS）恢复情况，并对比两组手术前后生活质量变化情况。结果实验组术后并发症率7．32％（3／41）与对照组12．20％（5／41）相比，差异无统计学意义（P〉0．05）。实验组术后骨块移位率2．44％（1／41）低于对照组19．51％（8／41），差异有统计学意义（P〈0．05）。实验组术后骨折愈合及完全负重时间与对照组相比，差异均无统计学意义（P〉0．05）。两组术前AOFAS评分差异无统计学意义（P〉0．05），相较于对照组，实验组术后2年、3年AOFAS评分均较高，差异有统计学意义（P〈0．05）。相较于对照组，术后3年，实验组精力、健康状况、生理功能、躯体疼痛、精神状态及生理职能评分均较高，差异有统计学意义（P〈0．05）。结论对后踝骨折患者予以空心钉内固定术时，由后前方置入空心钉，可减少骨块移位发生，显著改善患者踝关节功能，且有助于提高术后生活质量。Objective To investigate the efficacy of posteroanterior cannulated screw fixation in the treatment of fractures of posterior malleolus. Methods 82 patients with fractures of posterior malleolus from February 2012 to August 2014 were divided into 2 groups according to different surgical protocols, with 41 cases in each group. The two groups were treated with cannulated screw fixation, the control group was treated with anteroposterior cannulated screw fixation, and the experimental group was treated with posteroanterior cannulated screw fixation. The patients were followed up for 3 years, and the time of fracture healing and complete weight- bearing, complications, fracture displacement, and joint function recovery （AOFAS） were recorded in the two groups. The quality of life was compared between the two groups before and after the operation. Results There was no statistically significant difference in the incidence of postoperative complications in the experimental group and the control group [7.32% （3/41） vs. 12.20% （5/41）] （P〉0.05）. The rate of fracture displacement in the experimental group was 2.44% （1/41）, lower than that in the control group [（19.51%） （8/41）] （P〈O.05）. There were no statistically significant differences in the time of fracture healing and complete weight-bearing between the two groups （P〉0.05）. There was no statistically significant difference in the AOFAS score between the two groups before the operation （P〉0.05）; the AOFAS score in the experimental group was higher than that in the control group at 2 years and 3 years after operation （P〈0.05）. The scores of vitality, state of health, physical function, physical pain, mental state and physiological function in experimental group were higher than those in the control group at 3 years after operation （P〈0.05）. Conclusion Posteroanterior cannulated screw fixation in the treatment of fractures of posterior malleolus can reduce the occurrence of fracture displacement and improve the fu

关 键 词：空心钉 后踝骨折 踝关节功能 

分 类 号：R687.3[医药卫生—骨科学]