两种内固定治疗下胫腓联合损伤的疗效比较  

Effect comparison of two kinds of internal fixation in the treatment of distal tibiofibular syndesmosis injury

作　　者：苏鹏[1] 张如意 SU Peng;ZHANG Ru-yi(Dept of Orthopaedics,Beijing Shijingshan Hospital,Beijing 100043,China)

机构地区：[1]北京市石景山医院骨科,北京100043

出　　处：《临床骨科杂志》2020年第6期881-883,887,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较带袢钢板弹性固定与传统螺钉内固定治疗下胫腓联合损伤的疗效。方法将60例下胫腓联合损伤患者根据随机数字表法分为对照组(采用传统螺钉内固定,30例)和观察组(采用带袢钢板弹性固定,30例)。记录两组手术时间、术中钻孔角度、部分负重下地时间以及相关并发症。术后6、12个月根据AOFAS评分系统评价疗效。结果患者均获得随访,时间13~34个月。术中钻孔角度观察组大于对照组(P<0.05),部分负重下地时间观察组短于对照组(P<0.05)。两组手术时间及并发症发生率比较差异均无统计学意义(P>0.05)。AOFAS评分优良率:术后6个月观察组明显高于对照组(P<0.05);术后12个月两组比较差异无统计学意义(P>0.05)。结论与传统螺钉内固定相比,使用弹性内固定治疗下胫腓联合损伤,手术更便于操作,可获得较好的临床疗效。Objective To compare the clinical effect of Endobutton plate elastic fixation and traditional screw internal fixation for the treatment of distal tibiofibular syndesmotic injury.Methods Sixty patients with tibiofibular syndesmosis injuries were divided into control group and observation group by random assignment,with 30 cases in each group.The control group was used traditional screw internal fixation,and the observation group was used Endobutton plate elastic fixation.The time of operation,the drilling angle during operation,the time of partial loading and the related complications were recorded.At 6,12 months postoperation,the efficacy was evaluated according to the American Orthopedic Association for foot and ankle surgery(AOFAS)scoring system.Results Both groups were followed up for 13~34 months.The intraoperative drilling angle in the observation group was larger than that in the control group(P<0.05),the time of partial loading in the observation group was shorter than that in the control group(P<0.05).There were no significant differences in the operation time and complication incidence rate between the two groups(P>0.05).At 6 months after the operation,and excellent and good rate of AOFAS score in the observation group was significantly higher than that in the control group(P<0.05);there was no significant difference between the two groups at 12 months after the operation(P>0.05).Conclusions Compared with traditional screw internal fixation,the elastic fixation for lower tibiofibular syndesmosis injury patients is more convenient,with better effect.

关 键 词：下胫腓联合损伤 弹性固定 传统螺钉内固定 

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