皮质骨螺钉固定与带线骨锚修复治疗旋后外旋型踝关节骨折合并下胫腓联合损伤的疗效观察  

Therapeutic Effects of Cortical Bone Screw Fixation and Suture Bone Anchor Repair in the Treatment of Supination and External Rotation Ankle Fractures With Distal Tibiofibular Syndesmosis Injury

作　　者：邓建海 郭新丽 Deng Jianhai;Guo Xinli(Henan Rongjun Hospital,Xinxiang 453000,China)

机构地区：[1]河南省荣军医院,河南新乡453000

出　　处：《哈尔滨医药》2022年第3期42-44,共3页Harbin Medical Journal

摘　　要：目的观察皮质骨螺钉固定与带线骨锚修复治疗旋后外旋型踝关节骨折合并下胫腓联合损伤的临床疗效。方法选取116例旋后外旋型Ⅲ度、Ⅳ度踝关节骨折合并下胫腓联合损伤患者为研究对象,依据治疗方法不同将其分为螺钉固定组和骨锚修复组,各58例。螺钉固定组采用皮质骨螺钉固定术进行治疗;骨锚修复组采用带线骨锚修复术进行治疗,观察两组患者术中、术后相关指标,踝关节功能评分量表(AOFAS)评分,下胫腓联合韧带间隙距离和重叠距离,并发症发生情况。结果螺钉固定组手术时间、术中出血量、住院天数、骨折愈合时间与骨锚修复组比较,均无统计学差异(P>0.05);术后1、3个月,骨锚修复组AOFAS评分均显著高于螺钉固定组,且差异均有统计学意义(P<0.05),术后6个月,两组AOFAS评分比较差异无统计学意义(P>0.05);术后3、6个月,两组患者下胫腓联合韧带间隙距离和重叠距离比较差异无统计学意义(P>0.05);骨锚修复组并发症总发生率明显低于螺钉固定组,且差异均有统计学意义(P<0.05)。结论皮质骨螺钉固定术与带线骨锚修复术在术后半年疗效相近,但带线骨锚修复术短期内踝关节功能恢复更快,并发症更少。Objective To observe the clinical effects of cortical bone screw fixation and suture bone anchor repair in the treatment of supination and external rotation ankle fractures with distal tibiofibular syndesmosis injury.Methods 116 patients with supination and external rotation type III and IV ankle fractures and distal tibiofibular syndesmosis injury were selected as study subjects.According to the treatment method,they were divided into screw fixation group and bone anchor repair group with 58 cases in each group.The screw fixation group received cortical bone screw fixation,while the bone anchor repair group received suture bone anchor repair.The related intraoperative and postoperative indexes,the American orthopedic foot ankle society(AOFAS)scores,the gap distance and overlap distance of distal tibiofibular syndesmosis,and the occurrence of complications in the two groups were observed.Results There were no significant differences between the two groups in terms of operation time,intraoperative blood loss,hospital stay,and fracture healing time(P>0.05).At 1 month and 3 months after operation,the bone anchor repair group had significantly higher AOFAS scores than the screw fixation group,and the differences were statistically significant(P<0.05).At 6 months after operation,there was no significant difference in AOFAS scores between the two groups(P>0.05).At 3 and 6 months after operation,there were no significant differences between the two groups in the gap distance and overlap distance of distal tibiofibular syndesmosis(P>0.05).The total incidence of complications in the bone anchor repair group was significantly lower than that in the screw fixation group,and the difference was statistically significant(P<0.05).Conclusion Cortical bone screw fixation and suture bone anchor repair have similar curative effects in half a year after operation.However,suture bone anchor repair can promote the recovery of ankle function in a short term,with few complications.

关 键 词：皮质骨螺钉固定 带线骨锚修复 旋后外旋型踝关节骨折 下胫腓联合韧带 

分 类 号：R457.2[医药卫生—治疗学]