内固定治疗老年踝关节骨折的疗效评价  

Clinical evaluation of internal fixation in the treatment of elderly patients with ankle fractures

作　　者：马楠[1] 张会增[1] 张同润 睢更义 刘玉波[1] MA Nan;ZHANG Hui-zeng;ZHANG Tong-run;SUI Geng-yi;LIU Yu-bo(Dept of Traumatic Orthopaedics,Jizhong Energy Xingtai Mining Refco Group Ltd General Hospital, Xingtai, Hebei 054000,China)

机构地区：[1]冀中能源邢台矿业集团有限责任公司总医院创伤骨科

出　　处：《临床骨科杂志》2020年第1期61-65,共5页Journal of Clinical Orthopaedics

摘　　要：目的评价手术复位内固定治疗老年踝关节骨折的效果。方法对116例老年踝关节骨折患者复位后分别实施克氏针、Herbert空心螺钉、解剖复合钢板、解剖锁定钢板、1/3管型钢板内固定治疗。记录骨痂出现时间、骨折愈合时间、完全负重时间。术后12个月采用疼痛VAS评分评价患者负重状态下疼痛程度,采用Baird-Jackson踝关节评分系统评价患者踝关节功能,采用AOFAS踝-后足评分系统评价距下关节功能。结果患者均顺利完成手术。116例均获得随访,时间12~24个月。术后4~8(6.02±1.17)周出现骨痂,骨折愈合时间3~5(3.74±0.41)个月,完全负重时间3~7(4.67±0.65)个月。术后12个月,VAS评分为1~4(2.04±0.46)分,Baird-Jackson踝关节评分为70~96(81.45±3.96)分,AOFAS踝-后足评分为75~98(88.36±3.84)分。未出现内固定松动或断裂、骨折再移位等并发症。结论对于有手术指针的老年踝关节骨折患者,在恢复患者的解剖复位后,采用内固定手术有利于患者术后的早期功能锻炼和踝关节功能恢复。Objective To evaluate the effects of surgery reduction and internal fixation for elderly patients with ankle fracture.Methods The 116 elderly patients with ankle fracture were treated by Kirschner wire,Herbert hollow screw,anatomical composite plate,anatomical locking plate and 1/3 tube plate internal fixation after operative reduction.The occurrence time of callus,healing time of fracture and full loading time were recorded.At 12 months after operation,pain VAS was used to evaluate the degree of pain in the state of load,Baird-Jackson ankle score system was used to evaluate the ankle function of the patients,and the AOFAS ankle-hindfoot score system was used to evaluate the function of the subtalar joint.Results All surgeries of patients were completed successfully.The 116 cases patients were followed-up for 12~24 months.The occurrence time of callus was 4~8(6.02±1.17)weeks,healing time of fracture was 3~5(3.74±0.41)months,full loading time was 3~7(4.67±0.65)months.At 12 months postoperation,VAS was 1~4(2.04±0.46)points,Baird-Jackson system score was 70~96(81.45±3.96)points,AOFAS ankle-hindfoot score was 75~98(88.36±3.84)points.There were no complications such as loosening of internal fixation,fracture and re-displacement of fracture.Conclusions For the elderly patients with ankle fractures with surgical indications,after anatomical reduction,internal fixation is conducive to early postoperative functional exercise and ankle function recovery.

关 键 词：踝关节骨折 内固定 老年人 踝关节功能 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]