Buttress与空心钉治疗旋后外旋Ⅳ度踝关节骨折的效果比较  

Comparison of the effect of Buttress and hollow nail in the treatment of AF of grade Ⅳ supination and external rotation

作　　者：王浩宇 钱钧[1] 吴盼 WANG Haoyu;QIAN Jun;WU Pan(People's Hospital of Quzhou City,Zhejiang 324000,China)

机构地区：[1]浙江省衢州市人民医院,衢州324000

出　　处：《浙江创伤外科》2023年第11期1999-2002,共4页Zhejiang Journal of Traumatic Surgery

基　　金：浙江省医学会临床医学专项资金项目(2022ZYC-B22)。

摘　　要：目的比较Buttress与空心钉治疗旋后外旋Ⅳ度踝关节骨折(AF)的效果。方法回顾性选取2020年1月至2023年1月在本院诊治的90例旋后外旋Ⅳ度AF患者为研究对象,按照手术方法的不同分为A组(n=40)、B组(n=50)。A组给予空心钉固定治疗,B组给予Buttress固定治疗。比较两组患者的手术指标、术后3个月的骨折愈合情况、并发症发生率、美国足踝骨科协会(AOFAS)优良率以及术前、术后3个月的AOFAS评分。结果B组手术时间、术中出血量均显著高于A组(P<0.05),住院时间、下地行走时间及完全负重时间均显著低于A组(P<0.05)。两组患者术后3个月的骨折愈合优良率及并发症发生率比较差异均无统计学意义(P>0.05)。与术前比较,两组患者术后3个月的AOFAS评分显著升高(P<0.05),且B组AOFAS评分及其优良率均显著优于A组(P<0.05)。结论空心钉与Buttress治疗旋后外旋Ⅳ度AF患者,在促进骨折愈合、减少并发症方面的效果相当;与空心钉治疗比较,Buttress治疗更有助于促进患者术后恢复,恢复患者正常关节功能,但后者具有手术操作时间长、出血量大的不足。Objective To compare the effect of Buttress and hollow nail in the treatment of ankle fracture(AF)of grade Ⅳ supination and external rotation.Methods 90 AF patients of grade Ⅳ supination and external rotation who diagnosed and treated in our hospital from January 2020 to January 2023 were retrospectively studied,and they were divided into group A(n=40)and group B(n=50)according to different surgical methods.Patient in group A was treated with hollow nail fixation and in group B was treated with Buttress fixation.The surgical indexes,fracture healing at 3 months after surgery,occurrence rate of complications,excellent and good rate of American orthopedic foot and ankle society(AOFAS)and AOFAS score before and 3 months after surgery were compared.Results The surgical time and intraoperative blood loss in group B were apparently higher than those in group A(P<0.05),and the time of hospitalization,walking,full weight-bearing were apparently lower than those in group A(P<0.05).The excellent and good rate of fracture healing,and occurrence rate of complications at 3 months after surgery between the both groups had no statistical difference(P>0.05).Compared with before surgery,the AOFAS score of both groups at 3 months after surgery was significantly increased(P<0.05),and the AOFAS score,and excellent and good rate in group B were significantly better than those in group A(P<0.05).Conclusion Hollow nail and Buttress had the same effect on promoting the fracture healing and reducing the complications in AF patients of grade Ⅳ supination and external rotation.Compared with hollow nail,Buttress was more helpful to promote the postoperative recovery and restore the normal joint function of patients,but the latter had the shortcomings of long operation time and large amount of bleeding.

关 键 词：BUTTRESS 空心钉 旋后外旋Ⅳ度踝关节骨折 治疗效果 

分 类 号：R687.3[医药卫生—骨科学]