带线锚钉修复踝关节骨折合并三角韧带损伤疗效观察  

Repair of ankle joint fractures with deltoid ligament injury with wire anchor

作　　者：陈斌[1] 李岩[1] 李飞[1] 高远鹏[1] 张宇 刘晓虎[1] 苏昱煊 王东[1] 孙海钰[1] CHEN Bin;LI Yan;LI Fei;GAO Yuan-peng;ZHANG Yu;LIU Xiao-hu;SU Yu-xuan;WANG Dong;SUN Hai-yu(Department of Orthopaedics,Second Hospital of Shanxi Medical University,Taiyuan,Shanxi 030000,China)

机构地区：[1]山西医科大学第二医院骨科,山西太原030000

出　　处：《中国骨与关节损伤杂志》2021年第6期583-585,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨采用带线锚钉修复踝关节骨折合并三角韧带损伤的重要性与手术效果。方法回顾性分析自2013-08—2018-10手术治疗的29例合并三角韧带损伤的踝关节骨折,术中采用带线锚钉修复三角韧带。如果三角韧带在内踝止点附近断裂,在内踝止点处置入带线锚钉;如果在距骨止点附近断裂,在距骨止点处置入带线锚钉,再用尾部缝线编织缝合断端;如果是中部断裂,用韧带线缝合。结果29例均获得随访,随访时间平均26(12~36)个月。随访期间无切口感染、骨折延迟愈合、骨折不愈合、内固定失败等并发症发生。术后摄X线片测量健侧内踝间隙为(3.42±0.35)mm,患侧内踝间隙为(3.50±0.25)mm,差异无统计学意义(P>0.05)。末次随访时足踝功能AOFAS评分为83~97(95.62±2.61)分,其中优18例,良10例,可1例。末次随访时疼痛VAS评分为0~2(1.11±0.05)分。结论三角韧带对于踝关节的稳定至关重要,合并三角韧带损伤的踝关节骨折应积极手术探查损伤位置并重建三角韧带,同时配合系统的康复锻炼,术后可以使患者得到满意的功能恢复。Objective To investigate the importance and surgical effect of repairing ankle fractures with deltoid ligament injuries with wire anchor.MethodsA retrospective analysis of 29 cases of ankle fractures with deltoid ligament injury surgically treated from August 2013 to October 2018 was conducted.The deltoid ligament was repaired with wire anchor during the operation.If the deltoid ligament was ruptured near the medial malleolus attachment point,a threaded anchor was inserted at the medial malleolus attachment point;If the deltoid ligament was ruptured near the talus attachment point,a threaded anchor was inserted at the talus attachment point,and then the broken end was woven with the tail of suture;If the deltoid ligament was ruptured in the middle,it can be sutured with ligament suture.ResultsAll cases were followed up for an average of 26(12-36)months.During the follow-up period,there were no complications such as wound infection,delayed fracture union,nonunion fracture,and failure of internal fixation.In the postoperative X-ray,the measurement of the contralateral medial malleolus gap was(3.42±0.35)mm,and the affected side medial malleolus gap was(3.50±0.25)mm,the difference was not statistically significant(P>0.05).At the end of follow-up,the AOFAS score was 83-97(95.62±2.61)points,of which 18 cases were excellent,10 cases good,and 1 case fair.The pain VAS score at the last follow-up was 0-2(1.11±0.05)points.ConclusionThe deltoid ligament is essential for the stability of the ankle joint.For ankle fractures with triangular ligament injury the location of the injury should be actively explored and the triangular ligament is reconstructed.At the same time,with systematic rehabilitation exercises,the ankle joint function can have satisfactory recovery after surgery.

关 键 词：踝关节骨折 三角韧带损伤 带线锚钉 内固定 韧带修复 

分 类 号：R687.3[医药卫生—骨科学]