关节镜辅助下Endobutton钢板治疗下胫腓联合分离的临床疗效研究  

Clinical Effect of Arthroscopy-assisted Endobutton Plate in the Treatment of Lower Tibiofibular Syndesmosis Sepa⁃ration

作　　者：陈贵彬[1] 孙赞 杨宏栋[1] CHEN Gui-bin;SUN Zan;YANG Hong-dong(Department of Orthopedics,Dongguan Humen Hospital,Dong-guan,Guangdong,523900,China)

机构地区：[1]东莞市虎门医院骨科,广东东莞523900 [2]东莞市中医院骨七科,广东东莞523005

出　　处：《黑龙江医学》2022年第11期1330-1333,共4页Heilongjiang Medical Journal

基　　金：东莞市社会科技发展(一般)项目(202050715020124)。

摘　　要：目的:探讨关节镜辅助下Endobutton钢板治疗下胫腓联合分离的临床效果。方法:选取2018年6月—2020年6月在样本医院接受治疗的86例踝关节骨折合并下胫腓联合分离者患者作为研究对象,按照术中内固定方法的不同分为A组和B组,每组各43例。A组采用关节镜辅助下Endobutton钢板治疗,B组采用创统螺钉内固定治疗,比较两组患者的手术相关指标、术中C臂透视次数、术后6个月随访踝关节功能、拍摄X线片评估两组患者骨折愈合情况、术后并发症发生情况。结果:两组患者的手术时间比较,差异无统计学意义(t=1.985,P>0.05),A组术中出血量、术后1个月的VAS评分、术中C臂透视次数、术后负重时间明显低于B组,差异有统计学意义(t=8.634、2.251、13.746、4.714,P<0.05);两组患者治疗后的下胫腓间隙(TBCS)、下胫腓重叠距离(TBOL)、内侧关节间隙(MW)指标均明显改善,两组比较,差异无统计学意义(t=1.372、0.309、0.622,P>0.05);两组患者的踝关节优良率比较,差异无统计学意义(χ^(2)=0.816,P>0.05);A组并发症的发生率为6.98%,B组并发症的发生率为13.95%,两组比较,差异无统计学意义(χ^(2)=1.117,P>0.05)。结论:关节镜辅助下Endobutton钢板治疗下胫腓联合分离的疗效与传统螺钉内固定治疗效果相似,能够减轻术后踝关节的疼痛,可提供更加精准的弹性内固定,有利于早期活动,踝关节功能的恢复较快,术后并发症少。Objective:To explore the clinical effect of arthroscopy-assisted Endobutton plate in the treatment of lower tibiofibu⁃lar syndesmosis separation.Methods:A total of 86 patients with ankle fractures and lower tibiofibular syndesmosis separation who were treated in the hospital from June 2018 to June 2020 were enrolled as the research objects.According to different intraopera⁃tive internal fixation methods,they were divided into group A(arthroscopy-assisted Endobutton plate)and group B(traditional screw internal fixation),with 43 cases in each group.The operation-related indexes,times of intraoperative C-arm fluoroscopy,an⁃kle function after six months of follow-up,fracture healing by X-ray films and postoperative complications were compared between the two groups.Results:There was no statistically significant difference in the operation time between the two groups(t=1.985,P>0.05).The intraoperative blood loss,VAS score at 1 month after surgery,times of intraoperative C-arm fluoroscopy and postopera⁃tive weight-bearing time in group A were significantly lower than those in group B,with statistically significant difference(t=8.634,2.251,13.746,4.714,P<0.05).After treatment,tibiofibular clear space(TBCS),tibiofibular overlap(TBOL)and medial joint space space(MW)in both groups significantly improved,and there was no statistically significant difference between the two groups(t=1.372,0.309,0.622,P>0.05).There was no statistically significant difference in good rate of ankle joint between the two groups(χ^(2)=0.816,P>0.05).The incidence of complications in group A was 6.98%,and the incidence of complications in group B was 13.95%,and there was no statistically significant difference between the two groups(χ^(2)=1.117,P>0.05).Conclusion:The cu⁃rative effect of arthroscopy-assisted Endobutton plate and traditional screw internal fixation is comparable on lower tibiofibular syndesmosis separation.It can alleviate postoperative ankle pain,provide more precise elastic internal fixation,and is conductive to early a

关 键 词：关节镜辅助 Endobutton钢板治疗 下胫腓联合分离 疗效 

分 类 号：R657.4[医药卫生—外科学]