下胫腓螺钉固定在Lauge-Hansen旋前-外旋型踝关节骨折合并下胫腓联合分离治疗中的应用效果  

Efficacy of Distal Tibiofibular Screw Fixation in Treatment of Lauge-Hansen Pronation External Rotation Ankle Fracture Complicated by Distal Tibiofibular Syndesmosis Separation

作　　者：刘圣星 王隆辉 王运楷 LIU Sheng-xing;WANG Long-hui;WANG Yun-kai(The First Department of Orthopedics,the Second Affiliated Hospital ofHainan Medical College,Haikou 570100,China)

机构地区：[1]海南医学院第二附属医院骨一科,海口570100

出　　处：《南昌大学学报（医学版）》2018年第3期49-52,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨下胫腓螺钉固定在Lauge-Hansen旋前-外旋型踝关节骨折合并下胫腓联合分离治疗中的应用效果。方法将92例Lauge-Hansen旋前-外旋型踝关节骨折合并下胫腓联合分离患者按治疗方法不同分为研究组和对照组,每组46例。2组均采用内固定方法对后踝、外踝、内踝解剖位置进行整复治疗,研究组在此基础上应用下胫腓螺钉内固定治疗。比较2组骨折愈合时间、术后即刻和术后6个月下胫腓间隙及下胫腓重叠距离、术后1年踝关节功能评分的差异。结果研究组骨折愈合时间为(13.65±2.44)周,对照组为(13.92±2.04)周,2组骨折愈合时间比较差异无统计学意义(P>0.05);术后即刻和术后6个月,2组下胫腓间隙及下胫腓重叠距离比较差异均无统计学意义(P>0.05);术后1年,研究组和对照组踝关节功能评分优良率分别为78.26%、71.74%,2组比较差异无统计学意义(P>0.05)。结论 Lauge-Hansen旋前-外旋型踝关节骨折合并下胫腓联合分离治疗过程中修复后踝、外踝、内踝后是否进行下胫腓固定对骨愈合与踝关节功能恢复效果影响不大。ObjectiveTo investigate the clinical effect of distal tibiofibular screw fixation on Lauge-Hansen pronation external rotation ankle fracture complicated by distal tibiofibular syndesmosis separation. Methods Ninety-two patients with Lauge-Hansen pronation external rotation ankle fracture and distal tibiofibular syndesmosis separation were divided into study group and control group,with 46 patients in each group.Both groups were treated with internal fixation posterior,lateral and medial malleoli.In addition,the study group was given distal tibiofibular screw fixation.The fracture healing time,tibiofibular space,tibiofibular overlap and ankle function were compared between the two groups. Results The fracture healing time was（13.65±2.44） weeks in research group and（13.92±2.04） weeks in control group（ P 〉0.05）.At 1 year after operation,the excellent and good rate of ankle function of was 78.26% in study group and 71.74% in control group（ P 〉0.05）.Furthermore,there were no significant differences in tibiofibular space and overlap between the two groups immediately and 6 months after operation（ P 〉0.05）. Conclusion After reduction of the posterior,lateral and medial malleoli,distal tibiofibular screw fixation has no significant effect on fracture healing and ankle function recovery in patients with Lauge-Hansen pronation external rotation ankle fracture and distal tibiofibular syndesmosis separation.

关 键 词：下胫腓联合 踝关节骨折 固定 Lauge-Hansen分类 旋前-外旋型 

分 类 号：R683.42[医药卫生—骨科学]