关节镜辅助治疗踝部骨折合并下胫腓联合损伤  

Arthroscopy assisted treatment of ankle fracture accompanied with inferior tibiofibular syndesmosis tears

作　　者：张国辉[1] 刘艳辉[1] 李华[1] 王泉[1] 田伟峰 肖春来[1] 关玉龙[1] ZHANG Guo-hui;LIU Yan-hui;LI Hua;WANG Quan;TIAN Wei-feng;XIAO Chun-lai;GUAN Yu-long(Hengshui People's Hospital,Hebei Medical University,Hengshui 053000,China)

机构地区：[1]河北医科大学附属衡水市人民医院,河北衡水053000

出　　处：《中国矫形外科杂志》2021年第19期1804-1807,共4页Orthopedic Journal of China

摘　　要：[目的]评价踝关节镜在踝关节骨折合并下胫腓骨联合损伤治疗中的应用价值。[方法]2016年12月-2019年12月,对80例踝关节骨折合并下胫腓骨联合损伤的患者行手术治疗。其中,35例采用开放复位内固定治疗(开放组),45例患者采用关节镜辅助复位内固定(镜下组)。比较两组早期效果。[结果]两组患者均顺利完成手术,术中无严重血管、神经损伤等并发症。镜下组手术时间、切口长度、术中出血量和术后下地行走时间均显著优于开放组(P<0.05)。两组患者均获随访6个月以上。镜下组恢复完全负重时间显著早于开放组(P<0.05)。随时间推移,两组患者VAS评分显著减少,A0FAS评分显著增加(P<0.05)。术后3、6个月,镜下组的VAS和A0FAS评分均显著优于开放组(P<0.05)。[结论]关节镜可术中评估踝关节骨折合并下胫腓骨联合损伤情况,有利于损伤的复位固定。[Objective]To evaluate the value of ankle arthroscopy application in the treatment of ankle fractures accompanied with inferior tibiofibular syndesmosis injuries.[Methods]From December 2016 to December 2019,80 patients underwent surgical treatment for ankle fractures accompanied with inferior tibiofibular syndesmosis injuries.Among them,35 patients were treated with open reduction and internal fixation,while the other 45 patients were treated with arthroscopy-assisted reduction and internal fixation.The early clinical outcomes were compared between the two groups.[Results]The arthroscopic group proved significantly superior to the open group in terms of operation time,incision length,intraoperative blood loss,and the time to return walking postoperatively(P<0.05).All patients in both groups were followed up for more than 6 months.The arthroscopic groups resumed full weight bearing significantly earlier than the open group(P<0.05).The VAS scores decreased significantly,whereas the AOFAS scores increased significantly in both groups over time postoperatively(P<0.05).At 3 months and 6 months after operation,the arthroscopic group proved significantly superior to the open group in terms of VAS and AOFAS scores(P<0.05).[Conclusion]Arthroscopy can evaluate the ankle fracture combined with inferior tibiofibular syndesmosis tears during the operation,which is beneficial to the reduction and fixation of the injuries.

关 键 词：踝关节镜 踝部骨折 下胫腓骨联合损伤 临床疗效 

分 类 号：R683.42[医药卫生—骨科学]