关节镜下清理辅助治疗旋后外旋型踝关节骨折的手术疗效  

Surgical efficacy of arthroscopic debridement assisted treatment for supination-external rotation ankle fractures

作　　者：谭小波[1] 莫世赞 李轶 李翱翔[1] 魏人前 白锡光 TAN Xiaobo;MO Shizan;LI Yi;LI Aoxiang;WEI Renqian;BAI Xiguang(Second Department of Orthopaedics,Qingyuan Hospital Affiliated to Guangzhou Medical University,Qingyuan People’s Hospital,Qingyuan 511518,Gunagdong,China)

机构地区：[1]广州医科大学附属清远医院(清远市人民医院)骨科二区,广东清远511518

出　　处：《外科研究与新技术》2024年第1期23-26,共4页Surgical Research and New Technique

基　　金：广东省医学科学技术研究基金项目(B2020102);清远市科技计划项目(190910104568622)。

摘　　要：目的探讨关节镜下清理辅助治疗旋后外旋型踝关节骨折的手术疗效。方法回顾性选取2018年1月—2023年1月收治的52例旋后外旋型踝关节骨折患者作为研究对象,按照是否使用关节镜下清理分为试验组(28例)和对照组(24例)。试验组采用切开复位内固定术后行关节镜下清理踝关节,对照组采用切开复位内固定术。比较两组的手术时间,术中出血量、术后6个月步行时踝关节疼痛视觉模拟评分法(VAS)评分、术后6个月踝关节最大背伸活动度及踝关节的Baird-Jackson功能评分。结果试验组患者的手术时间为(81.25±11.75)min,长于对照组的(72.08±11.31)min,差异有统计学意义(P<0.05);试验组患者的术中出血量为(47.32±18.48)mL,多于对照组的(42.70±17.25)mL,但差异无统计学意义(P>0.05);试验组的术后6个月步行时踝关节疼痛VAS评分(1.67±1.05)少于对照组(2.62±1.31),差异有统计学意义(P<0.05),试验组的踝关节最大背伸活动度[(18.71±4.78)°],大于对照组[(13.54±6.11)°],差异有统计学意义(P<0.05);试验组患者的踝关节功能优于对照组,差异具有统计学意义(P<0.05)。结论旋后外旋型踝关节骨折内固定术后使用关节镜下清理,可减少术后踝关节疼痛,增加踝关节背伸活动范围,改善踝关节术后功能,临床效果满意,值得推广。Objective To investigate the surgical efficacy of arthroscopic debridement assisted treatment for supination-external rotation ankle fractures.Methods A total of 52 patients with supination-external rotation ankle fractures admitted to the Qingyuan Hospital Affiliated to Guangzhou Medical University from January 2018 to January 2023 were retrospectively divided into group A(28 cases)and group B(24 cases)according to whether arthroscopic cleaning was used during surgery.Group A underwent arthroscopic assisted ankle joint cleaning after open reduction and internal fixation surgery,while group B underwent traditional open reduction and internal fixation surgery.The operative time and intraoperative blood loss were compared between group A and group B.At the postoperative 6th month,visual analogue scale(VAS)scores of ankle pain during walking,maximum ankle dorsiflexion range of motion,and Baird-Jackson ankle score were compared between group A and group B.Results The operative time in group A was(81.25±11.75)min,significantly longer than that in group B,(72.08±11.31)min(P<0.05).The intraoperative blood loss in group A was(47.32±18.48)mL,more than that in group B,(42.70±17.25)mL,and the difference was not statistically significant(P>0.05).At the postoperative 6th month,the VAS score for ankle pain during walking in group A(1.67±1.05)was lower than that in group B(2.62±1.31),while the maximum ankle dorsiflexion range of motion in group A[(18.71±4.78)°]was larger than that in group B[(13.54±6.11)°],with a statistically significant difference(P<0.05).The ankle joint function of group A was better than that of group B,with a statistical difference(P<0.05).Conclusion Arthroscopic debridement at the time of open reduction and internal fixation in supination-external rotation ankle fractures may reduce postoperative ankle pain,increase ankle dorsiflexion range of motion,and improve postoperative ankle function,which is worth being recommended.

关 键 词：踝关节骨折 关节镜 内固定 

分 类 号：R683.4[医药卫生—骨科学]