不同手术入路与体位在踝关节骨折内固定手术中的临床应用  

Clinical Application of Different Surgical Approach and Position in Internal Fixation of Ankle Fracture

作　　者：魏绪卿 WEI Xu-qing(Department of Orthopaedics, First People's Hospital of Guannan County, Guannan, Jiangsu Province, 222500 China)

机构地区：[1]灌南县第一人民医院骨科,江苏灌南222500

出　　处：《中外医疗》2019年第8期69-71,共3页China & Foreign Medical Treatment

摘　　要：目的对不同组实施不同手术入路与体位,探究其在踝关节骨折内固定手术中的临床应用。方法于该院诊治的2014年5月—2018年9月踝关节骨折患者中随机抽取40例患者,男23例,女17例,年龄范围19～83岁,平均年龄(45.36±5.78)岁;对照组:体位采用仰卧位,固定顺序采用外内后侧手术入路;治疗组:体位可以先采用健侧卧位后采用仰卧位和先俯卧位随后仰卧位进行,其内固定顺序为后外侧手术入路。比较两组的临床效果。结果治疗组后骨折愈合时间为(12.23±0.25)周低于对照组(t=8.186,P<0.05),手术出血量为(146.55±26.72)mL低于对照组(t=12.131,P<0.05),手术时间为(47.22±13.18)min短于对照组(t=8.042,P<0.05)。治疗组优良率(90%)高于对照组(χ2=16.210,P<0.05)。结论后外侧手术入路,可有效降低骨折愈合时间、手术出血量、手术时间,提高AOFAS足踝评分,是一项值得推广的手术方案。Objective To investigate the clinical application of different surgical approaches and postures in different groups in the treatment of ankle fracture internal fixation. Methods A total of 40 patients with ankle fractures from May 2014 to September 2018 were enrolled in our hospital. There were 23 males and 17 females with an age range of 19-83 years old, with an average age of (45.36±5.78) years old. The position was in the supine position, and the external sequence was used in the posterior lateral approach. The treatment group: the position can be performed in the supine position and the prone position and then in the supine position. The internal fixation sequence was posterolateral surgery. The clinical effects of the two groups were compared. Results After the treatment group, the fracture healing time was (12.23±0.25)weeks lower than the control group (t=8.186, P<0.05), and the surgical bleeding volume was (146.55±26.72)mL lower than the control group (t=12.131, P<0.05). The operation time was (47.22±13.18)min, shorter than the control group (t=8.042, P<0.05). The excel-lent rate of the treatment group (90%) was higher than that of the control group (X^2=16.210, P<0.05). Conclusion The poste-rior lateral approach can effectively reduce the fracture healing time, the amount of surgical bleeding, the operation time, and improve the AOFAS ankle score. It is a surgical plan worthy of promotion.

关 键 词：手术入路 踝关节骨折内固定手术 三踝骨折 

分 类 号：R687[医药卫生—骨科学]