侧卧位后外侧入路治疗踝部旋后-外旋型Ⅲ、Ⅳ度骨折的临床应用价值  

Clinical Application Value of Lateral Supine Posterolateral Approach in the Treatment ofⅢandⅣDegree Ankle Fractures of Supination-external Rotation Type

作　　者：陆晨星 陈凤华[1] 许炜民 刘琰 徐力 LU Chenxing;CHEN Fenghua;XU Weimin;LIU Yan;XU Li(Department of Orthopedics and Traumatology,Taizhou Traditional Chinese Medicine Hospital,Taizhou 225300,China)

机构地区：[1]泰州市中医院骨伤科,江苏泰州225300

出　　处：《中国医学创新》2024年第4期1-5,共5页Medical Innovation of China

基　　金：泰州市中医药科技发展项目(TZ202120)。

摘　　要：目的:探讨侧卧位后外侧入路治疗踝部旋后-外旋型Ⅲ、Ⅳ度骨折的临床价值。方法:回顾性分析2021年10月—2023年4月在泰州市中医院骨伤科接受切开复位内固定术的80例踝关节骨折患者的资料,其中40例选择仰卧位后内侧入路的患者设为对照组,40例选择侧卧位后外侧入路手术设为研究组。对两组的手术情况及术后情况进行对比,并对比两组手术前后的踝关节情况。结果:两组术中失血量对比,差异无统计学意义(P>0.05);在手术用时、住院时间、骨折愈合时间方面对比,研究组均比对照组更短,差异均有统计学意义(P<0.05);研究组术后并发症总发生率比对照组更低,差异有统计学意义(P<0.05)。术后第1~3天,与对照组相比,研究组疼痛评分、C反应蛋白、白细胞介素-6均更低,差异均有统计学意义(P<0.05)。术后8周,研究组的踝关节活动度、足踝功能评分均高于对照组,差异均有统计学意义(P<0.05)。结论:在旋后-外旋型Ⅲ、Ⅳ度踝关节骨折患者切开复位内固定术中,选择侧卧位后外侧入路可在不增加术中失血量的情况下,获得比后内侧入路更好的临床疗效,其对于患者足踝功能、踝关节活动受限等情况均可有效改善,还可减轻术后患者的疼痛感受和炎症反应,降低术后发生并发症的风险,使患者得以顺利出院,对骨折的愈合起到促进作用。Objective:To investigate the clinical value of lateral supine posterolateral approach in the treatment ofⅢandⅣdegree ankle fractures of supination-external rotation type.Method:The data of 80 patients with ankle fractures who underwent open reduction and internal fixation in the Orthopedics and Traumatology Department of Taizhou Traditional Chinese Medicine Hospital from October 2021 to April 2023 were retrospectively analyzed.Among them,40 patients who chose supine position posterolateral approach were set as control group,and 40 patients who chose lateral position posterolateral approach were set as study group.The operative and postoperative conditions of the two groups were compared,and the ankle joint conditions before and after operation of the two groups were compared.Result:There was no significant difference in intraoperative blood loss between the two groups(P>0.05);the operation time,hospital stay and fracture healing time of the study group were shorter than those of the control group,the differences were statistically significant(P<0.05);the incidence of postoperative complications in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).The pain score,C reactive protein and interleukin-6 of the study group were lower than those of the control group on the 1st to 3rd day after surgery,the differences were statistically significant(P<0.05).At 8 weeks after surgery,the ankle joint motion and foot and ankle function score of the study group were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion:In the open reduction and internal fixation surgery for patients with supination-external rotation typeⅢandⅣankle joint fractures,choosing the lateral supine position posterolateral approach can achieve better clinical efficacy than the posterior medial approach without increasing intraoperative blood loss,it can effectively improve ankle function and limited ankle joint activity in patients,redu

关 键 词：旋后-外旋型 踝关节骨折 切开复位内固定术 后外侧入路 后内侧入路 

分 类 号：R687.3[医药卫生—骨科学]