关节镜辅助下闭合复位经皮固定微创手术治疗踝关节周围骨折的临床观察  

Therapeutic effects of minimally invasive arthroscopic assisted closed reduction and percutaneous fixation on periarticular fractures of ankle

作　　者：张晔[1] Zhang Ye(Department of Orthopedics,Linyi Traditional Chinese Medical Hospital,Linyi 276002,China)

机构地区：[1]临沂市中医医院骨科,临沂276002

出　　处：《中国实用医刊》2024年第3期5-8,共4页Chinese Journal of Practical Medicine

摘　　要：目的探究关节镜辅助下闭合复位经皮固定微创手术治疗踝关节周围骨折的效果。方法抽取2020年6月至2022年10月临沂市中医医院收治的106例踝关节周围骨折患者,按随机数字表法分为对照组与观察组,每组53例。对照组行常规切开复位内固定术治疗,观察组行关节镜辅助下闭合复位经皮固定微创手术治疗。比较两组手术指标(手术时间、术中出血量、切口长度、骨折愈合时间及住院时间)、并发症发生率。采用Baird-Jackson踝关节功能评分评估两组治疗前后踝关节功能,并进行比较。比较两组治疗前后骨性标志物[骨钙素、骨碱性磷酸酶(BALP)、β-胶原降解产物(β-CTX)]水平。结果两组手术时间比较差异未见统计学意义(P>0.05);观察组术中出血量少于对照组,切口长度、骨折愈合时间及住院时间短于对照组,差异有统计学意义(P<0.05)。术后3个月,观察组Baird-Jackson评分表中疼痛评分、功能评分、活动度评分均高于对照组(P均<0.05)。术后3个月,观察组骨钙素、BALP水平均高于对照组,β-CTX低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率(3.77%,2/53)低于对照组(15.09%,8/53),差异有统计学意义(χ2=3.98,P=0.046)。结论关节镜辅助下闭合复位经皮固定微创手术治疗踝关节周围骨折,可有效减轻手术创伤,减少术中出血量,改善骨代谢,促进踝关节功能恢复,降低并发症发生风险。Objective To investigate the effects of minimally invasive arthroscopic assisted closed reduction and percutaneous fixation in the treatment of periarticular fractures of ankle.Methods A total of 106 patients with periarticular fractures of ankle admitted to Linyi Traditional Chinese Medical Hospital from June 2020 to October 2022 were selected,and they were divided into control group and observation group,with 53 cases in each group.The control group was treated by conventional open reduction and internal fixation,while the observation group was treated by minimally invasive arthroscopic assisted closed reduction and percutaneous fixation.The surgical indicators(operation time,intraoperative bleeding volume,incision length,fracture healing time and hospital stay)and incidence of complications were compared between the two groups.The Baird-Jackson ankle function score was used to assess the ankle function before and after treatment,and the scores of the two groups were compared.The preoperative and postoperative levels of bone markers,including osteocalcin,bone alkaline phosphatase(BALP)andβ-isomerized C-terminal telopeptide of type-I collagen(β-CTX),were compared between the two groups.Results There was no significant difference in operation time between the two groups(P>0.05).The observation group had less intraoperative bleeding volume,shorter incision length,shorter fracture healing time,and shorter hospital stay,compared with the control group(P<0.05).Three months after operation,the Baird-Jackson ankle function scores,including pain score,functional score and activity score,of the observation group were higher than those of the control group(all P<0.05).Compared with the control group,the levels of osteocalcin and BALP of the observation group were significantly higher,and theβ-CTX level was lower 3 months after operation(P<0.05).The incidence of complications in the observation group(3.77%,2/53)was lower than that in the control group(15.09%,8/53),with significant difference(χ2=3.98,P=0.046).Conclusion

关 键 词：关节镜 踝关节周围骨折 闭合复位 经皮固定 踝关节功能 骨性标志物 并发症 

分 类 号：R687.3[医药卫生—骨科学]