外踝骨折不同内固定方式治疗的临床疗效分析  

Analysis of Clinical Effectiveness of Two Different Internal Fixation Methods for Treating Lateral Malleolus Fracture

作　　者：贾乐 葛建华 单旭彬[2] 马月 邓勇 鲁晓波 Jia Le;Ge Jianhua;Shan Xubin(Department of Bone and Joint Surgery,Affiliated Hospital of Southwest Medical University,Sichuan Provincial Laboratory of Orthopaedic Engineering,Luzhou,Sichuan 646000;Department of Orthopedics,The First People s Hospital of Yibin,Yibin,Sichuan 644000,China)

机构地区：[1]西南医科大学附属医院骨与关节外科·四川省骨科植入器械研发应用技术工程实验室,四川泸州646000 [2]宜宾市第一人民医院骨科,四川宜宾644000

出　　处：《四川医学》2021年第8期778-782,共5页Sichuan Medical Journal

基　　金：四川省科技厅三方课题(编号:14ZC0058)。

摘　　要：目的探讨新型外踝内固定接骨板治疗外踝骨折的临床疗效。方法收集我院2009年1月至2017年12月收治外踝骨折患者36例临床资料。按选择内固定物不同,分A组(16例)和B组(20例),A组内固定物为新型外踝内固定接骨板,B组为临床常用外踝接骨板,常规手术操作外踝复位分别两种接骨板内固定。术后观察手术切口愈合,评估骨折愈合及踝关节功能康复等。结果两组患者手术切口各有1例乙级愈合,余均甲级愈合,B组下胫腓联合螺钉断裂1例。两组患者治疗手术时间及住院时间比较差异无统计学意义(P>0.05);术后3个月、6个月A组X线片评分优于B组,差异有统计学意义(P<0.05),但术后9个月及12个月两组比较差异无统计学意义(P>0.05);术后12个月两组Baird-Jackson踝关节功能评分差异无统计学意义(P>0.05)。结论新型外踝内固定接骨板与临床常用外踝接骨板具有相似的临床操作、影像学及踝关节功能恢复效果,并具有操作简单、固定可靠,踝关节功能恢复满意,建议外踝Weber B型、部分Weber A型或距外踝远端8 cm内Weber C型骨折适合选择应用。Objective To compare and analyze the clinical effectiveness of a new type of internal fixation plate in the treatment of external malleolus fracture.Methods 36 patients with lateral malleolus fracture were treated from January 2009 to December 2017.All patients were divided into group A(16 cases)and group B(20 cases)according to the choice of internal fixators.A new type of external malleolus internal fixator was used in group A,and the commonly used internal fixator with Johnson&Johnson medical device was used in group B.Conventional surgical restoration of the lateral malleolus was performed with two internal fixators respectively.The results of incision healing,fracture healing and ankle function recovery were assessed after operation.Results All patients were followed up for 12~48 months.1 screw fixing lower tibiofibular joint ruptured in group B.Except 1 case of grade B healing in each group,all other cases were of grade A healing.There was no statistically difference between the two groups in operative time and hospitalization time(P>0.05).The X-ray scores of group A were better than group B at 3 and 6 months after operation(P<0.05),and not statistically different between the two groups at 9 and 12 months after operation(P>0.05).There was no statistically difference in ankle function score between the two groups at 12 months after operation(P>0.05).Conclusion The new type of external malleolus internal fixator provided similar clinical and radiological outcomes and ankle function recovery effects compared with the common external malleolus plate of Johnson&Johnson medical devices.The operation is relatively simple and the fracture fixation is reliable,so it should be considered when treating displaced lateral malleolar fractures of type Weber B and some of type Weber A and C.

关 键 词：外踝骨折 接骨板 内固定 手术 

分 类 号：R683.42[医药卫生—骨科学]