防滑钢板和空心加压螺钉治疗后踝Plion骨折的疗效比较  

Antiskid steel plate versus cannulated compression screw in the treatment of posterior Plion fracture

作　　者：杜军 吴泉[1] 侯德胜[1] 鲁成[1] DU Jun;WU Quan;HOU De-sheng;LU Cheng(The Third Division of Orthopaedics,the First People′s Hospital of Chuzhou,Chuzhou,Anhui 239000,China)

机构地区：[1]滁州市第一人民医院骨三科,安徽滁州239000

出　　处：《中国临床研究》2021年第2期213-216,共4页Chinese Journal of Clinical Research

基　　金：安徽省卫生和计划生育委员会科研计划项目(2016QK037)。

摘　　要：目的比较防滑钢板和空心加压螺钉治疗Lauge-Hansen旋后外旋型Ⅲ、Ⅳ度、旋前外旋Ⅳ度合并有后踝Plion骨折的临床疗效。方法将2016年11月至2020年1月收治的60例严重踝关节骨折合并有后踝Plion骨折患者,按照后踝骨折固定方法不同分为防滑钢板组和空心加压螺钉组,各30例,比较两组患者手术时间、骨折愈合时间、并发症发生率及踝关节功能恢复情况。结果防滑钢板组的手术时间长于空心加压螺钉组,差异有统计学意义[(129.47±12.23)min vs(121.33±17.32)min,t=2.103,P<0.05)];两组骨折愈合时间及踝关节功能评分比较差异均无统计学意义(P>0.05)。两组患者术后6个月并发症(足踝肿胀、张力性水泡、切口裂开)的发生率比较,差异无统计学意义(P>0.05)。结论不论采用防滑钢板还是空心加压螺钉治疗Lauge-Hansen旋后外旋型Ⅲ、Ⅳ度、旋前外旋Ⅳ度的合并有的后踝Plion骨折均可达到理想的治疗效果,粉碎性且较大的后踝骨折块建议采用钢板固定效果更佳。Objective To compare the efficacy of antiskid steel plate and cannulated compression screw in the treatment of ankle fractures with posterior malleolus fragments of Lauge-Hansen supination external rotation typeⅢand typeⅣand pronation external rotation typeⅣ.Methods Sixty patients with severe ankle fractures with posterior malleolus Plion fracture treated from November 2016 to January 2020 were selected and divided into anti-skid steel plate group and cannulated compression screw group according to different posterior malleolus fixation strategies(n=30,each).The operation time,fracture healing time,complication rate and recovery of ankle joint function were compared between two groups.Results The operating time in anti-skid steel plate group was significantly longer than that in cannulated compression screw group[(129.47±12.23)min vs(121.33±17.32)min,t=2.103,P<0.05)].There were no statistical differences in fracture healing time,ankle function score and postoperative complications(ankle swelling,tension blister,incision dehiscence)6 months after surgery between two groups(P>0.05).Conclusion In the treatment of ankle fractures with posterior malleolus fracture of Lauge-Hansen supination external rotation typeⅢand typeⅣand pronation external rotation typeⅣ,both anti-skid steel plate and cannulated compression screw can achieve the ideal treatment effect,and plate fixation is recommended for comminuted and large posterior malleolus fractures.

关 键 词：防滑钢板 空心加压螺钉 后踝Plion骨折 

分 类 号：R687.3[医药卫生—骨科学]