手术与手法复位治疗踝关节骨折的效果比较  

Comparison of the effect of operation and manipulation reduction on ankle fracture

作　　者：张碧文 Zhang Biwen(Department of Orthopedics,the People's Hospital of Xianju County,Zhejiang 317300,China)

机构地区：[1]浙江省仙居县人民医院骨一科,317300

出　　处：《中国基层医药》2019年第19期2319-2322,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省医学会临床科研基金项目(2015ZYC-115).

摘　　要：目的比较手术与手法复位治疗踝关节骨折的临床效果,为临床提供指导。方法选择仙居县人民医院2015年3月至2018年3月收治的踝关节骨折患者88例为观察对象,依据治疗方法不同分为两组,手术组48例,应用手术治疗;手法组40例,应用手法复位治疗。两组患者均随访半年,比较两组患者复位优良率、住院时间、住院费用、骨折愈合时间、踝关节功能恢复优良率、踝关节功能评分及并发症发生率。结果手术组复位优良率为93.75%(45/48),高于手法组的75.00%(30/40)(χ2=6.092,P<0.05);手术组住院时间、住院费用分别为(17.56±3.12)d、(14 265.56±1 543.78)元,手法组分别为(6.42±2.25)d、(2 565.56±487.69)元,两组差异均有统计学意义(t=18.856、46.019,均P<0.05);手术组骨折愈合时间为(9.12±1.25)周,短于对照组的(11.56±2.36)周(t=6.200,P<0.05);两组治疗后半年踝关节功能评分差异无统计学意义(P>0.05);手术组踝关节功能恢复优良率为95.83%(46/48),手法组为92.50%(37/40),差异无统计学意义(P>0.05);手术组并发症发生率为14.58%(7/48),高于手法组的2.50%(1/40)(χ2=3.855,P<0.05)。结论手术、手法复位治疗踝关节骨折均有较好的效果,两者各有优缺点,手法复位的治疗费用较手术治疗少、住院时间较手术治疗短,但骨折愈合时间长,可结合患者的病情、家庭经济情况制定合理的治疗方案。Objective To compare the clinical effect of operation and manual reduction in the treatment of ankle fracture and provide guidance for clinical practice. Methods From March 2015 to March 2018, 88 cases of ankle fracture who admitted and treated in the People's Hospital of Xianju County were selected as the observation objects.Forty-eight patients in the operation group were treated with surgery.Forty cases in the manipulation group were treated by manipulation reduction.The two groups were followed up for half a year, and the rate of excellent and good reduction, hospitalization time, hospitalization cost, fracture healing time, excellent and good recovery rate of ankle joint function, ankle joint function score and incidence of complications were compared between the two groups. Results The positive and negative rate of reduction in the operation group was 93.75%(45/48), which was higher than 75.00%(30/40) in the manipulation group(χ2=6.092, P<0.05). The length and cost of hospitalization in the operation group were (17.56±3.12)d,(14 265.56±1 543.78)CNY, respectively, which in the manipulation group were (6.42±2.25)d,(2 565.56±487.69)CNY, respectively.There were statistically significant differences between the two groups(t=18.856, 46.019, all P<0.05). The healing time of fracture in the operation group was (9.12±1.25)weeks, which was shorter than that in the manipulation group[(11.56±2.36)weeks](t=6.200, P<0.05). There was no statistically significant difference in ankle function score between the two groups(P>0.05). The excellent and good rate of ankle function recovery in the operation group was 95.83%(46/48), which in the manipulation group was 92.50%(37/40), there was no statistically significant difference(P>0.05). The incidence rate of complications in the operation group was 14.58%(7/48), which was higher than that in the manipulation group [2.50%(1/40)](χ2=3.855, P<0.05). Conclusion The treatment of ankle fracture by operation and manual reduction has good results, both of which have advantages

关 键 词：关节内骨折 踝关节 修复外科手术 骨折固定术 手法 骨科 住院时间 手术后并发症 对比研究 

分 类 号：R683.42[医药卫生—骨科学]