踝关节骨折切开复位内固定术后患者踝关节功能影响因素分析  

Influencing factors of ankle function in patients with ankle fracture after open reduction and internal fixation

作　　者：刘杰[1] 宋才[1] 梁西俊[1] 李俊[2] 张伟[1] 柴雷子[1] LIU Jie;SONG Cai;LIANG Xi-jun;LI Jun;ZHANG Wei;CHAI Lei-zi(Department of Traumatic Orthopaedics,the People′s Hospital of Bozhou City,Bozhou 236800,Anhui Province,China;Department of Orthopaedics,the Second People′s Hospital of Lu′an City,Lu′an 237000,Anhui Province,China)

机构地区：[1]亳州市人民医院创伤骨科,安徽亳州236800 [2]六安市第二人民医院骨一科,安徽六安237000

出　　处：《新乡医学院学报》2019年第11期1044-1047,共4页Journal of Xinxiang Medical University

基　　金：安徽省高校自然科学研究项目(编号:KJ2017A909)

摘　　要：目的探讨切开复位内固定治疗踝关节骨折的临床效果,并分析影响术后踝关节功能的相关因素。方法选择2014年3月至2017年3月亳州市人民医院收治的112例踝关节骨折患者为研究对象,所有患者行切开复位内固定术治疗,分别于术前及术后1 a应用美国足踝外科协会(AOFAS)的踝-后足评分系统评估患者踝关节功能,记录患者术后并发症发生情况,并分析影响踝关节功能的相关因素。结果112例踝关节骨折患者术后1 a AOFAS评分显著高于术前(P<0.01)。112例患者中,踝关节功能优良78例(69.64%),踝关节功能不良34例(30.36%);术后发生伤口愈合延迟5例,切口感染3例,腓骨肌腱疼痛1例,下肢深静脉血栓1例,均经对症处理后恢复;术后1 a,17例患者形成创伤性关节炎,11例患者出现局部皮肤麻木。单因素分析结果显示,患者的年龄、受伤至手术时间、术后并发症、是否坚持功能锻炼、是否取出内固定物与术后踝关节功能有关(P<0.05),而患者的性别、是否合并高血压和糖尿病、骨折原因、国际内固定研究学会分型、是否开放损伤、是否跟骨牵引与术后踝关节功能无关(P>0.05)。Logistic回归分析结果显示,坚持功能锻炼是踝关节功能的保护因素(P<0.05),而术后并发症是踝关节功能的危险因素(P<0.05)。结论切开复位内固定可以有效恢复踝关节骨折患者的踝关节功能;坚持功能锻炼是踝关节功能的保护因素,而术后并发症是踝关节功能的危险因素;踝关节骨折术后应积极防治并发症,并坚持功能锻炼。Objective To investigate the clinical effect of open reduction and internal fixation in the treatment of ankle fracture,and to analyze the related influencing factors of ankle function.Methods A total of 112 patients with ankle fracture admitted to Bozhou People′s Hospital from March 2014 to March 2017 were selected as the study subjects.All patients were treated with open reduction and internal fixation.The ankle function of patients was evaluated by the ankle hindfoot scale system of the American orthopaedic foot and ankle society(AOFAS)before and one year after operation.The postoperative complications were recorded and the related factors affecting the ankle function were analyzed.Results The AOFAS score of 112 patients with ankle fracture at one year after operation was significantly higher than that before operation(P>0.01).Among the 112 patients,78(69.64%)cases had excellent ankle function and 34(30.36%)cases had poor ankle function.Among the 112 patients,there were 5 cases of delayed wound healing,3 cases of wound infection,1 case of peroneal tendon pain and 1 case of deep venous thrombosis after operation;all patients recovered after symptomatic treatment.One year after operation,there were 17 patients with traumatic arthritis and 11 patients with local skin numbness.The univariate analysis showed that the age,time from injury to operation,postoperative complications,continuous functional exercise and the removal of internal fixator were related to ankle function(P>0.05);while the gender,hypertension and diabetes,fracture causes,the international society for internal fixation research classification,open injury and calcaneal traction were not related to ankle function(P>0.05).Logistic regression analysis showed that the continuous functional exercise was the protective factor for ankle function(P>0.05),while the postoperative complications were the risk factors for ankle function(P>0.05).Conclusions The open reduction and internal fixation can effectively restore the ankle function of patients with ank

关 键 词：踝关节骨折 切开复位内固定 踝关节功能 影响因素 

分 类 号：R274.12[医药卫生—中医骨伤科学]