两种内固定方法治疗踝关节骨折的疗效比较  

Efficacy comparison of two kinds of internal fixation methods foRtreatment of ankle fractures

作　　者：兰家平[1] 王志强[1] 李磊[1] 叶永杰[1] 阳波[1] 米宁[1] 刘东[1] 温洋 LAN Jia-ping;WANG Zhi-qiang;LI Lei;YE Yong-jie;YANG Bo;MI Ning;LIU Dong;WEN Yang(Dept of Foot-Ankle Surgery,the Central Hospital of Suining City,Suining,Sichuan 629000,China)

机构地区：[1]遂宁市中心医院足踝外科,四川遂宁629000

出　　处：《临床骨科杂志》2022年第4期576-580,共5页Journal of Clinical Orthopaedics

基　　金：四川省医学会医学青年创新科研课题(编号:Q19051)。

摘　　要：目的比较可吸收螺钉与加压空心螺钉治疗踝关节骨折的疗效。方法根据随机数字表法将86例踝关节骨折患者分为可吸收螺钉组(采用可吸收螺钉内固定治疗,43例)与加压空心螺钉组(采用加压空心螺钉内固定治疗,43例)。记录两组骨折愈合情况、扶拐情况以及术后并发症发生情况;采用Kofoed评分评价踝关节功能;采用健康调查简表(SF-36)评分评价患者生活质量;比较末次随访时踝关节活动度。结果患者均获得随访,时间12~24个月。骨痂开始形成时间、开始拄拐非负重时间、骨折愈合时间:两组比较差异均无统计学意义(P>0.05)。SF-36评分、Kofoed评分:两组术后12个月均高于术前(P<0.05);术后12个月可吸收螺钉组均高于加压空心螺钉组(P<0.05)。末次随访时,踝关节背伸、跖屈以及足部内翻、外翻两组比较差异均无统计学意义(P>0.05)。术后并发症发生率两组比较差异无统计学意义(P>0.05)。结论可吸收螺钉与加压空心螺钉内固定治疗踝关节骨折均可获得良好的疗效,但可吸收螺钉对患者功能恢复的效果更好。Objective To compare the effect of absorbable screw and compression cannulated screw in the treatment of ankle fracture.Methods According to the random numbeRtable method,86 patients with ankle fractures were divided into absorbable screw group and compression cannulated screw group,with 43 cases in each group,the absorbale screw group was performed with absorbale screw internal fixation,and the anotheRgroup was treated with compression cannulated screw.The fracture healing,the situation of walking with crutch and the occurrence of postoperative complications were recorded in the two groups.Ankle function was assessed by Kofoed score,and quality of life was assessed by the MOS item short from health survey(SF-36)score.The ankle range of motion was compared at the last follow-up.Results All patients were followed up foR12~24 months.There were no statistically significant differences in the time of callus formation,fracture healing time and time to start using crutches without weight-bearing between the two groups(P>0.05).SF-36 score and Kofoed score of two groups:at 12 months postoperation,they were higheRthan before surgery(P<0.05),and the absorbable screw group was higheRthan those in cannulated screw group(P<0.05).At the last follow-up,there were no statistical significances in dorsiflexion and plantaRflexion of ankle joint,varus and valgus of foot between the two groups(P>0.05).There was no significant difference in the incidence rate of postoperative complications between the two groups(P>0.05).Conclusions Both absorbable screw and compression cannulated screw are effective in the treatment of ankle fracture,while absorbable screw is more effective in functional recovery.

关 键 词：踝关节骨折 可吸收螺钉内固定 空心螺钉内固定 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]