经皮空心螺钉及钢板内固定在踝关节骨折治疗中的效果及对踝关节功能的影响  

Effect of percutaneous cannulated screw and steel-plate internal fixation in the treatment of ankle fractures and its impact on ankle function

作　　者：王猛 WANG Meng(Department of Orthopedics,Beijing Renhe Hospital,Beijing 102600,China)

机构地区：[1]北京市仁和医院骨一科,102600

出　　处：《中国实用医药》2023年第7期52-54,共3页China Practical Medicine

摘　　要：目的分析经皮空心螺钉及钢板内固定治疗踝关节骨折的效果及对踝关节功能的影响。方法60例踝关节骨折患者,行经皮空心螺钉及钢板内固定治疗,分析手术指标(术中出血量、手术时间、住院时间及并发症发生率),比较手术前后美国足踝骨科协会(AOFAS)踝-后足评分,评估踝关节功能恢复情况。结果60例患者手术均取得成功,平均手术时间为(98.85±6.20)min;平均出血量为(60.67±5.30)ml。随访6个月均未发生骨折不愈合、创伤性关节炎、内固定撕裂等恶性并发症,1例(1.67%)患者术后发生创口感染,经抗炎、抗感染等对症处理后恢复满意。60例患者骨折均愈合良好,踝关节功能优46例,良9例,可4例,差1例。术前,旋前外展型、旋前外旋型、旋后外旋型、旋后内收型AOFAS踝-后足评分分别为(51.67±5.94)、(50.98±6.72)、(51.23±6.06)、(52.71±8.32)分,术后6个月分别为(91.43±5.28)、(92.64±5.10)、(91.84±4.77)、(90.75±4.60)分。术后6个月,不同骨折分型患者AOFAS踝-后足评分均高于术前,差异有统计学意义(P<0.05)。结论经皮空心螺钉及钢板内固定治疗踝关节骨折疗效显著,临床应结合骨折类型选择科学恰当的复位及内固定方式,以促进患者踝关节功能恢复。Objective To analyze the effect of percutaneous cannulated screw and steel-plate internal fixation in the treatment of ankle fractures and its impact on ankle function.Methods 60 patients with ankle fractures were treated with percutaneous cannulated screws and steel-plate internal fixation,and the surgical indexes(intraoperative blood loss,operative time,hospital stay and complication rate)were analyzed,and the recovery of ankle function was assessed by the American Orthopaedic Foot and Ankle Society(AOFAS)anklehindfoot score before and after surgery.Results The surgery was successful in all 60 patients,with a mean operative time of(98.85±6.20)min;mean blood loss of(60.67±5.30)ml.No malignant complications such as non-healing fracture,traumatic arthritis,or tearing of internal fixation occurred in all patients at 6-month followup.1 patient(1.67%)had postoperative wound infection and recovered satisfactorily after symptomatic treatment such as anti-inflammatory and anti-infective treatment.The fractures healed well in all 60 patients,and the ankle function was excellent in 46 cases,good in 9 cases,acceptable in 4 cases,and poor in 1 case.At preoperatively,the AOFAS ankle-hindfoot scores of prerotation-abduction,prerotation-external rotation,supination-external rotation,and supination-adduction type types were(51.67±5.94),(50.98±6.72),(51.23±6.06)and(52.71±8.32)points;at 6 months postoperatively,those scores were(91.43±5.28),(92.64±5.10),(91.84±4.77),and(90.75±4.60)points.At 6 months postoperatively,the AOFAS ankle-hindfoot scores of patients with different fracture types were higher than those before surgery,and the difference was statistically significant(P<0.05).Conclusion Percutaneous cannulated screw and steel-plate internal fixation are effective in the treatment of ankle fracture.Scientific and appropriate reduction and internal fixation should be selected according to the fracture type to promote the functional recovery of ankle joint.

关 键 词：踝关节骨折 经皮空心螺钉 钢板内固定 踝关节功能 

分 类 号：R687.3[医药卫生—骨科学]