双股带线锚钉系统内固定治疗下胫腓联合损伤  

Double-strand suture anchor in the treatment of tibiofibular syndesmosis injury

作　　者：翁诗阳 伍凯[1] 林健[1] 黄寅骏 王秋根[1] 黄建华[1] Weng Shiyang;Wu Kai;Lin Jian;Huang Yinjun;Wang Qiugen;Huang Jianhua(Department of Orthopedic Trauma,South Hospital of First People’s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 201600,China)

机构地区：[1]上海交通大学附属第一人民医院南院创伤骨科,上海市201600

出　　处：《中国组织工程研究》2020年第33期5332-5337,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:下胫腓联合韧带损伤如诊断或治疗不及时,常易引起创伤性关节炎以及踝关节不稳定等后遗症,目前对于双股带线锚钉系统能否治疗下胫腓联合损伤尚无明确报道。目的:回顾性分析双股锚钉线固定治疗下胫腓联合损伤的临床疗效以及安全性。方法:选择2016年7月至2018年10月上海交通大学附属第一人民医院南院收治的踝关节骨折伴下胫腓联合损伤患者30例,随机分2组,每组15例。试验组采用双股锚钉线固定下胫腓联合,对照组采用下胫腓联合螺钉固定。术前记录患者年龄、性别、踝关节术前肿胀程度,拍摄踝关节三维CT以及踝关节正、侧位X射线片,术后1d及1.5,3,6,12个月拍摄踝关节正、侧位X射线片,并评估术后3,6,12个月美国足踝外科协会评分。结果与结论:①所有患者手术切口均Ⅰ期愈合,术后未出现下肢静脉血栓、感染、骨不连、锚钉松动等并发症;②术后3,6,12个月时,2组之间美国足踝外科协会评分相比,差异均无显著性意义;2组美国足踝外科协会评分均显著高于术前(P<0.05);③术后1年内,试验组有5例(33%)出现下胫腓联合增宽,对照组有2例(13%)出现下胫腓联合增宽;④结果表明,双股锚钉线固定治疗下胫腓联合损伤疗效确切,安全性高,但患者术后发生下胫腓联合再分离概率较高。BACKGROUND: The injury of tibiofibular syndesmosis ligament often leads to traumatic arthritis and ankle instability and other sequelae if the diagnosis or treatment of tibiofibular syndesmosis ligament injury is not timely. At present, there is no clear report on the treatment of tibiofibular syndesmosis ligament injury with anchor. OBJECTIVE: To retrospectively analyze the clinical efficacy and safety of double-strand anchor in the treatment of tibiofibular syndesmosis injury. METHODS: From July 2016 to October 2018, 30 cases of ankle fracture with lower tibiofibular syndesmosis injury were treated in South Hospital of First People’s Hospital Affiliated to Shanghai Jiao Tong University. The patients were randomly assigned to two groups(n=15). In the experimental group, the lower tibiofibular syndesmosis was fixed with double strands of suture anchors. In the control group, the lower tibiofibular syndesmosis was fixed with screw. Age, gender, and preoperative swelling degree of the ankle joint were preoperatively recorded. Three-dimensional CT images of the ankle and X-ray anteroposterior and lateral images of the ankle were captured. X-ray films of ankle joint were obtained 1 day and 1.5, 3, 6, 12 months after operation. American Orthopaedic Foot and Ankle Society scores were assessed at 3, 6 and 12 months after surgery. RESULTS AND CONCLUSION:(1) All surgical incisions healed at stage I, and no complications such as lower limb venous thrombosis, infection, nonunion of bone, loose anchor was found.(2) At 3, 6 and 12 months after surgery, there was no significant difference in American Orthopaedic Foot and Ankle Society scores between the two groups. American Orthopaedic Foot and Ankle Society scores were significantly higher than that before surgery in both groups(P<0.05).(3) Within one year after the operation, 5 cases(33%) in the experimental group and 2 cases(13%) in the control group showed the enlargement of tibiofibular syndesmosis.(4) Results suggested that double-strand suture anchor treatment of tibi

关 键 词：骨 骨折 踝关节 内固定 下胫腓联合损伤 带线锚钉 并发症 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]