下胫腓联合损伤患者分别采用三种疗法临床干预的回顾性研究  

Retrospective study on clinical intervention of patients with lower tibiofibular syndesmosis injury treated with three different therapies

作　　者：王世辉[1] 陈颖 张宁[1] 刘增兵[1] 王金广 WANG Shi-hui;CHEN Ying;ZHANG Ning;LIU Zeng-bing;WANG Jin-guang(The Second Department of Hand and Foot Surgery,Hengshui Fourth People's Hospital,Hengshui,Hebei,053000,China)

机构地区：[1]衡水市第四人民医院手足外二科,河北053000 [2]衡水市第四人民医院关节骨二科,河北053000

出　　处：《中国骨与关节杂志》2023年第6期433-440,共8页Chinese Journal of Bone and Joint

基　　金：衡水市科技计划项目(2020014053Z)。

摘　　要：目的 探讨下胫腓联合损伤患者分别采用3种疗法临床干预的疗效。方法 纳入2020年12月至2021年7月我院收治的318例下胫腓联合损伤患者,随机分为对照1组(采用螺钉固定)、对照2组(采用锚钉内固定)和观察组(采用Endobuton带袢钢板弹性固定),比较3组患者手术相关指标、踝-后足功能各维度评分、临床相关指标,分析3组患者治疗后临床疗效的统计学差异。结果 观察组患者手术时间、术中出血显著多于对照1组和对照2组患者,住院时间显著短于对照1组和对照2组患者;观察组患者治疗后反常步态、踝后足稳定性、前后运动、后足运动、足部对线、地面步行、功能与自主活动及支撑情况、最大步行距离、疼痛评分显著高于对照1组和对照2组患者;观察组患者治疗后下胫腓间隙显著小于对照1组和对照2组患者,下胫腓重叠距离显著大于对照1组和对照2组患者;观察组治愈人数显著高于对照1组和对照2组患者(Z=52.628,P <0.05)。结论 与采用螺钉和锚钉线固定相比,采用Endobuton带袢钢板弹性固定治疗下胫腓联合损伤的临床疗效更佳。Objective To investigate the effect of three kinds of clinical interventions on patients with lower tibiofibular syndesmosis injury.Methods From December 2020 to July 2021,318 patients with lower tibiofibular syndesmosis injury in Department of Orthopedics,the Fourth People's Hospital of Hengshui City were randomly divided into control group 1(with screw fixation),control group 2(with anchor wire fixation)and observation group(with endobutton loop plate elastic fixation).The statistical differences of clinical related indicators were compared among the three groups.Results The operation time and intraoperative bleeding of the observation group were significantly more than those of the control group 1 and control group 2,and the hospitalization time and medical expenses of the observation group were significantly lower than those of the control group 1 and control group 2;After treatment,the abnormal gait,ankle hindfoot stability,fore-and-aft movement,hindfoot movement,foot alignment,ground walking,function,autonomous activity and support,maximum walking distance and pain score in the observation group were significantly higher than that in control group 1 and control group 2;After treatment,the lower tibiofibular space of observation group was significantly smaller than that of control group 1 and control group 2,and the lower tibiofibular overlap distance was significantly larger than that of control group 1 and control group 2;The number of patients cured in the observation group was significantly higher than that in the control group 1 and control group 2(Z=52.628,P<0.05).Conclusions Compared with screw and anchor line fixation,endobutton elastic plate fixation is more effective in the treatment of tibiofibular syndesmosis injury.

关 键 词：下胫腓联合损伤 螺钉内固定术 锚钉内固定术 带袢钢板弹性固定术 

分 类 号：R683.4[医药卫生—骨科学]