踝关节骨折合并下胫腓联合韧带损伤患者行手术固定治疗的效果分析  

Analysis of the treatment effect of surgical fixation in ankle fracture with lower tibiofibular syndesmosis injury

作　　者：郑耿彦 陈国勋[1] 方雄明 刘贻运[1] ZHENG Gengyan;CHEN Guoxun;FANG Xiongming;LIU Yiyun(Guangzhou 12th People’s Hospital,Guangzhou 510620,China)

机构地区：[1]广州市第十二人民医院,广州510620

出　　处：《广州医药》2022年第6期75-78,共4页Guangzhou Medical Journal

摘　　要：目的 探究合并下胫腓联合韧带损伤的踝关节骨折患者实施手术固定治疗的临床价值。方法 遴选2018年1月—2020年12月70例合并下胫腓作者联合韧带损伤的踝关节骨折患者,根据随机数字表法分2组,开展石膏外固定治疗35例(记对照组),开展手术内固定治疗35例(记观察组),评估2组治疗优良率、治疗康复情况、踝关节功能(Kofoed评分)以及日常生活能力(ADL评分)、术后并发症率。结果 观察组治疗优良率94.29%相较对照组77.14%更高(P<0.05);观察组康复速率更快,二次手术率更低(P<0.05);术前2组Kofoed评分、ADL评分比较,均无统计学差异(P>0.05),术后观察组Kofoed评分、ADL评分较对照组更高(P<0.05);观察组术后并发症率低于对照组(P<0.05)。结论 对合并下胫腓联合韧带损伤的踝关节骨折患者开展实施手术内固定治疗,对骨折早期愈合及修复韧带损伤具有显著价值,降低二次手术率及控制术后并发风险,促进关节功能早日恢复,实现理想的临床疗效。Objective To explore the clinical value of surgical fixation in patients with ankle fracture with lower tibiofibular syndesmosis injury.Methods A total of 70 patients with ankle fracture and lower tibiofibular syndesmosis injury from January 2018 to December 2020 were selected and divided into two groups according to the random number table method.Thirty-five cases were treated with external plaster fixation(control group) and 35 cases were treated with internal surgical fixation(observation group).The treatment and rehabilitation outcomes, ankle function(Kofoed score) and ability of daily living(ADL score),postoperative complication incidence rate of the two groups were evaluated.Results The effective rates of treatment were 94.29% and 77.14% in observation group and control group(P<0.05).The observation group has a faster recovery rate and a lower rate of secondary operations(P<0.05).There were no significant difference in Kofoed score and ADL score between the two groups before operation(P>0.05).After operation, the Kofoed score and ADL score in the observation group were significantly higher than those in the control group(P<0.05). The postoperative complication incidence in the observation group was significantly lower than that in the control group(P<0.05).Conclusions The implementation of internal surgical fixation in patients with ankle fracture and lower tibiofibular syndesmosis injury had significant value for early fracture healing and ligament injury repair, reduced the secondary operation rate and controlling the postoperative complication risk, promoted the early recovery of joint function and achieved ideal clinical effect.

关 键 词：踝关节骨折 胫腓联合韧带损伤 手术固定治疗 关节功能 

分 类 号：R687.3[医药卫生—骨科学]