锚钉修复与皮质螺钉固定治疗踝关节骨折合并下胫腓联合损伤的临床疗效比较  

Clinical comparison of anchor repair and cortical screw fixation in the treatment of ankle fracture combined with inferior tibiofibular joint injury

作　　者：韩沐 周克浩 薛虎 孙春光[1] 孙月柏[1] Han Mu;Zhou Kehao;Xue Hu;Sun Chunguang;Sun Yuebai(Department of Orthopedics,Funing County People's Hospital,Yancheng 224400,China)

机构地区：[1]阜宁县人民医院骨科,江苏盐城224400

出　　处：《足踝外科电子杂志》2023年第2期53-57,82,共6页Electronic Journal of Foot and Ankle Surgery

基　　金：2018年盐城市医学科技发展计划项目(YK2018083)。

摘　　要：目的探究踝关节骨折合并下胫腓联合损伤患者采用锚钉修复与皮质螺钉固定治疗的临床效果。方法选择阜宁县人民医院骨科2020年5月至2021年10月收治的踝关节骨折合并下胫腓联合损伤患者82例。根据治疗方案的不同分为对照组(皮质螺钉固定,n=39)与观察组(锚钉修复治疗,n=43),比较两组手术相关指标,于术前、术后6个月拍摄踝关节X线片来测量内踝间隙、距骨倾斜角,评估复位维持效果,采用美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足功能评分评估两组踝关节功能优良率,另统计并发症发生率以评估手术安全性。结果观察组与对照组比较:手术时间[(98.75±21.03)min vs(121.08±27.65)min]、术中透视次数[(15.93±4.75)次vs(23.75±6.42)次]、住院时间[(14.94±2.05)d vs(17.26±2.18)d]、骨折愈合时间[(12.37±1.10)周vs(13.57±1.21)周],P<0.05;术后内踝间隙[(2.39±0.92)mm vs(3.18±1.01)mm]、距骨倾斜角[(4.32°±2.05°)vs(6.15°±2.29°)],P<0.05;踝关节功能优良率(93.02%vs 76.92%),P<0.05;并发症发生率(4.65%vs 25.64%),P<0.05。结论对踝关节骨折合并下胫腓联合损伤患者采用锚钉修复治疗,操作简单且骨折愈合良好,复位维持效果较好,有利于踝关节功能恢复,且可降低并发症风险。Objective To compare the clinical effect of anchor repair and cortical screw fixation for the treatment of the injury of the inferior tibiofibular ligament in the patients with ankle fracture combined with inferior tibiofibular ligament injury.Methods From May 2020 to October 2021,82 patients with ankle fracture combined with hypotibiofibular syndesmosis injury were selected from the Department of Orthopedics of Funing County People’s Hospital.The two groups were divided into the control group(cortical screw fixation,n=39)and the observation group(anchor repair,n=43)according to different treatment plans.The operative indicators of the two groups were compared,and the effect of reduction and maintenance was evaluated by taking ankle X-ray films to measure medial malleolus space and talus tilt angle before and 6 months after surgery.The ankle-posterior foot score of the American Orthopedic Foot and Ankle Society(AOFAS)was used to evaluate the good and excellent ankle function rate of the two groups,and the incidence of complications was calculated to evaluate the surgical safety.Results Comparison between observation group and control group:Operation time[(98.75±21.03)min vs(121.08±27.65)min],intraoperative fluoroscopy times[(15.93±4.75)times vs(23.75±6.42)times],hospital stay[(14.94±2.05)days]vs(17.26±2.18)days],fracture healing time[(12.37±1.10)weeks vs(13.57±1.21)weeks],P<0.05;Postoperative medial malleolus space[(2.39±0.92)mm vs(3.18±1.01)mm],talus angle[(4.32°±2.05°)vs(6.15°±2.29°)],P<0.05;The excellent and good rate of ankle joint function was 93.02%vs 76.92%,P<0.05;The incidence of complications was 4.65%vs 25.64%,P<0.05.Conclusion Anchor repair for ankle fracture combined with tibiofibular syndesmosis injury is simple and has good fracture healing,good reduction and maintenance effect,which is beneficial to the recovery of ankle function and can reduce the risk of complications.

关 键 词：踝关节骨折 下胫腓联合损伤 锚钉修复 皮质螺钉固定 关节功能 

分 类 号：R684.3[医药卫生—骨科学]