TightRope弹性固定联合下胫腓韧带功能性全修复治疗下胫腓联合损伤  

TightRope elastic fixation combined with functional total repair of inferior tibiofibular ligament in treatment of distal tibiofibular syndesmosis injury

作　　者：薛阳 赵永杰 邓明明 付炳金[1] 尹刚[1] 刘颖[1] 孙广超[1] XUE Yang;ZHAO Yongjie;DENG Mingming;FU Bingjin;YIN Gang;LIU Ying;SUN Guangchao(Department of Foot and Ankle Surgery,Binzhou Medical University Hospital,Binzhou Shandong,256603,P.R.China)

机构地区：[1]滨州医学院附属医院足踝外科,山东滨州256603

出　　处：《中国修复重建外科杂志》2023年第8期964-969,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的研究TightRope弹性固定联合下胫腓韧带功能性全修复治疗下胫腓联合损伤的临床疗效。方法回顾性分析2020年1月—2022年1月收治且符合选择标准的34例下胫腓联合损伤患者临床资料,按照手术方式分为改良组(采用TightRope弹性固定联合下胫腓韧带功能性全修复)和对照组(采用下胫腓螺钉固定修复),每组17例。两组患者年龄、性别、身体质量指数、骨折分型等基线资料比较差异均无统计学意义(P>0.05)。记录两组患者手术时间、术中出血量及并发症发生情况;术后采用美国矫形足踝协会(AOFAS)评分、踝关节跖屈和背伸活动度评价患者踝关节功能恢复情况;末次随访时进行患者满意度调查。结果两组患者均获随访,随访时间8~20个月,中位时间13个月。改良组手术时间及术中出血量均显著多于对照组(P<0.05)。改良组无感染及复位不良等并发症发生,仅有1例患者于术后6个月发生TightRope线结反应;对照组发生2例复位不良、1例下胫腓螺钉断裂、1例皮下感染(经抗感染治疗后好转);两组并发症发生情况比较差异无统计学意义(P>0.05)。末次随访时改良组AOFAS评分及踝关节跖屈、背伸活动度均明显优于对照组(P<0.05)。改良组和对照组患者满意度分别为94.1%和82.4%,差异有统计学意义(P<0.05)。结论Tight-Rope弹性固定联合下胫腓韧带功能性全修复方法治疗下胫腓联合损伤,固定强度足够,与传统螺钉固定相比可取得更好临床疗效。Objective To study the effectiveness of TightRope elastic fixation combined with functional total repair of the inferior tibiofibular ligament in the treatment of distal tibiofibular syndesmosis injury.Methods The clinical data of 34 patients with distal tibiofibular syndesmosis injury who met the selection criteria between January 2020 and January 2022 were retrospectively analyzed,and they were divided into improved group(TightRope elastic fixation combined with functional total repair of inferior tibiofibular ligament)and control group(distal tibiofibular screw fixation)according to the surgical methods,with 17 cases in each group.There was no significant difference in age,gender,body mass index,fracture type,and other baseline data between the two groups(P>0.05).The operation time,intraoperative blood loss,and complications were recorded in the two groups.The American Orthopaedic Foot and Ankle Society(AOFAS)score,ankle metatarsal flexion and dorsal extension range of motion were used to evaluate the ankle function.The patient satisfaction survey was conducted at last follow-up.Results All 34 patients were followed up 8-20 months,with a median of 13 months.The operation time and intraoperative blood loss in the improved group were significantly longer than that in the control group(P<0.05).In the improved group,no infection or poor reduction occurred,and only 1 patient had TightRope knot reaction at 6 months after operation.In the control group,there were 2 cases of poor reduction,1 case of lower tibiofibular screw rupture,and 1 case of subcutaneous infection(cured after antiinfection treatment).There was no significant difference in the incidence of complications between the two groups(P>0.05).At last follow-up,the AOFAS score and ankle metatarsal flexion and dorsal extension range of motion of the improved group were significantly better than those of the control group(P<0.05).The satisfaction rates of patients in the improved group and the control group were 94.1%and 82.4%,respectively,showing significant

关 键 词：弹性固定 TIGHTROPE 下胫腓关节损伤 下胫腓韧带 修复 

分 类 号：R687.3[医药卫生—骨科学]