踝关节骨折合并下胫腓联合韧带损伤临床治疗分析  

Clinical analysis of ankle joint fracture combined with syndesmosis ligament injury

作　　者：陆黎明[1] 刘进炼[1] 张叶松[1] 凡桂勇[1] 孙斌[1] LU Li-ming;LIU Jin-lian;ZHANG Ye-song;FAN Gui-yong;SUN Bin(Department of Orthopedics,Suzhou Kowloon Hospital Affiliated to School of Medicine,Shanghai Jiao Tong University,Suzhou Jiangsu 215000,China)

机构地区：[1]上海交通大学医学院附属苏州九龙医院骨科,江苏苏州215000

出　　处：《局解手术学杂志》2018年第8期574-577,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的比较几种治疗踝关节骨折合并下胫腓联合韧带损伤方法的临床效果。方法选取2014年1月至2017年12月我院收治的103例踝关节骨折合并下胫腓联合韧带损伤患者,按照治疗方法分为保守治疗组(对照组),固定内外踝、下胫腓克氏针外固定手术治疗组(观察组1)以及固定内外踝、下胫腓螺钉固定、下腓联合韧带修复治疗组(观察组2),对比分析3组患者临床疗效。结果固定内外踝,下胫腓螺钉固定、下腓联合韧带修复治疗组骨愈合时间、骨不连发生率和二次治疗发生率显著低于保守治疗组及固定内外踝,下胫腓克氏针外固定手术治疗组,差异具有统计学意义(P<0.05),而骨愈合优良率显著高于保守治疗组及固定内外踝,下胫腓克氏针外定手术治疗组,差异具有统计学意义(P<0.05)。结论采用内外踝固定,下胫腓螺钉固定、下腓联合韧带修复治疗踝关节骨折合并下胫腓联合韧带损伤效果较好,而且骨不连发生率和二次治疗发生率低。Objective To compare the effects of several commonly used methods for the treatment of ankle joint fracture combined with syndesmosis ligament injury. Methods A total of 103 cases of ankle joint fracture combined with syndesmosis ligament injury patients in our hospital from Janurary 2014 to December 2017 were randomly divided into three groups according to treatment methods,including conservative treatment group,fixed internal and external malleolus,lower tibiofibersyn needle surgery group and fixed internal and external malleolus,tibiofibular screw fixation,fibular ligament repair treatment group,comparing the clinical effects of the three groups. Results The healing time and the incidence of nonunion of bone and secondary treatment of fixed internal and external malleolus,tibiofibular screw fixation,fibular ligament repair treatment group was significance decreased,comparing with conservative treatment group and fixed internal and external malleolus,lower tibiofibersyn needle surgery group,the differences were significant（ P 〈0.05）.And its excellent and good rate of bone healing significantly higher than conservative treatment group and fixed internal and external malleolus,lower tibiofibersyn needle surgery group,the differences were significant（ P〈0.05）. Conclusion The use of fixed internal and external malleolus,tibiofibular screw fixation,fibular ligament repair treatment are effective,with lower incidence of nonunion of bone and secondary treatment.

关 键 词：踝关节骨折 下胫腓联合韧带损伤 手术治疗 保守治疗 

分 类 号：R683.42[医药卫生—骨科学]