不同固定方式治疗跖跗关节骨折脱位的效果  

Effect of Different Fixation Methods on Sacroiliac Joint Fracture and Dislocation

作　　者：袁国辉 庄泽[1] YUAN Guohui;ZHUANG Ze(Department of Joint Surgery Trauma Orthopedics,The Third Affiliated Hospital of Zhongshan University,Guangzhou Guangdong 510630,China)

机构地区：[1]中山大学附属第三医院关节外科创伤骨科,广东广州510630

出　　处：《中国卫生标准管理》2020年第12期83-86,共4页China Health Standard Management

摘　　要：目的探讨不同固定方式治疗跖跗关节骨折脱位的效果。方法选择本院骨科2012年3月—2018年5月收治的63例跖跗关节骨折脱位患者,根据随机数字表法分为A组(15例,经关节螺钉固定)、B组(18例,背侧钢板固定)和C组(30例,两者联合固定)。术后随访1年,比较三组患者美国矫形外科足踝协会(AOFAS)评分、创伤性关节炎发生情况、解剖复位情况以及并发症发生情况。结果C组患者AOFAS评分低于A组和B组,差异具有统计学意义(P<0.05);C组患者创伤性关节炎发生率及术后并发症高于A组和B组,差异有统计学意义(P<0.05),解剖复位优良率低于A组和B组,差异具有统计学意义(P<0.05);A和B两组的解剖复位情况及关节炎发生率比较,差异无统计学意义(P>0.05)。结论跖跗关节骨折脱位采用经关节螺钉、背侧钢板固定治疗方式早期预后相近,经关节螺钉联合背侧钢板治疗可增加患者不良反应发生情况。临床应制定较为完善的跖跗关节骨折脱位分类系统来指导内固定的选择及为临床结果提供一个指南。Objective To investigate the effect of different fixation methods on sacroiliac joint fracture and dislocation.Methods 63 patients with sacroiliac joint fracture and dislocation in our department of orthopedics from March 2012 to May 2018 were selected.According to the random number table method,they were randomly divided into group A(15 cases,fixed by articular screws),group B(18 cases,dorsal plate fixation)and group C(30 cases,the two are fixed together).Followed up for 1 year after surgery,compared the AOFAS scores,the occurrence of traumatic arthritis,anatomical reduction and the occurrence of complications of the three groups.Results The AOFAS score of group C patients was lower than that of group A and group B,and the difference was statistically significant(P<0.05).The incidence of traumatic arthritis and postoperative complications in group C were higher than those in group A and B,and the difference was statistically significant(P<0.05).The excellent rate of anatomical reduction was lower than that of group A and group B,and the difference was statistically significant(P<0.05).There was no significant difference in the anatomic reduction and arthritis incidence between the A and B groups(P>0.05).Conclusion The early prognosis of sacroiliac joint fractures treated with transarticular screws and dorsal plate fixation is similar.Transarticular screws combined with dorsal plate treatment can increase the incidence of adverse reactions in patients.In clinical practice,a more comprehensive sacroiliac fracture dislocation classification system should be developed to guide the choice of internal fixation and provide a guide for clinical results.

关 键 词：跖跗关节骨折脱位 关节螺钉 背侧钢板 创伤性关节炎 解剖复位 联合治疗 

分 类 号：R687[医药卫生—骨科学]