环抱式固定技术和螺钉固定治疗下胫腓联合损伤的疗效比较  

Comparison of embrace fixation and screw fixation for inferior tibiofibular syndesmosis injury

作　　者：汪建 王琛涵 曹振鲁 丁小珩[1] 董全宇 Wang Jian;Wang Chenhan;Cao Zhenu;Ding Xiaoheng;Dong Quanyu(Department of Hand and Foot Microsurgery,The Hospital Affiliated to Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院手足显微外科,青岛266000

出　　处：《中华创伤骨科杂志》2024年第7期563-568,共6页Chinese Journal of Orthopaedic Trauma

摘　　要：目的比较环抱式固定技术与传统螺钉固定治疗下胫腓联合损伤的疗效。方法回顾性分析2018年4月至2021年9月青岛大学附属医院收治的125例踝关节骨折合并下胫腓联合损伤患者。男79例,女46例;年龄(25.4±11.2)岁。根据治疗方式不同分为观察组(75例,采用环抱式固定技术固定下胫腓联合)和对照组(50例,采用传统螺钉固定下胫腓联合)。通过比较两组患者间术后损伤侧的下胫腓联合前间距(AD)、下胫腓联合后间距(PD)、腓骨平移距离(FT)、腓骨旋转角度(FR)与正常侧的差值以评估复位效果,并比较两组患者的下胫腓固定时间及末次随访时的美国足踝外科协会(AOFAS)踝-后足评分、踝关节功能Olerud-Molander评分和疼痛视觉模拟评分(VAS)比较疗效。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。两组患者术中下胫腓固定时间、术后损伤侧FT与正常侧差值、疼痛VAS评分比较差异均无统计学意义(P>0.05);观察组患者的术后损伤侧AD、PD、FR与正常侧差值[0.1(-0.2,0.3)mm、0.1(-0.3,0.5)mm、-0.5(-1.1,0.8)°]、AOFAS踝-后足评分[96(93,100)分]、Olerud-Molander踝关节功能评分[95(90,100)分]均优于对照组患者[1.4(0.6,2.1)mm、1.5(0.9,2.2)mm、1.2(-3.8,3.7)°、93(89,96)分、90(85,100)分],差异均有统计学意义(P<0.05)。观察组中无重大并发症、骨不连发生。结论环抱式固定技术是踝关节骨折准确、有效的下胫腓联合固定方法。与传统螺钉固定相比,它具有更好的疗效。ObjectiveTo compare the embrace fixation and screw fixation in the treatment of inferior tibiofibular syndesmosis injury.MethodsA retrospective study was conducted of the 125 patients who had been treated for ankle fractures and distal syndesmotic injuries at The Hospital Affiliated to Qingdao University from April 2018 to September 2021.They were 79 males and 46 females with an age of(25.4±11.2)years.The patients were divided into 2 groups according to their fixation methods:an observation group of 75 cases subjected to embrace fixation and a control group of 50 cases subjected to conventional screw fixation.Their reduction was evaluated by comparing the disparities between the affected and normal sides in the anterior and posterior syndesmotic distances,fibular translation distance,and fibular rotation angle between the 2 groups after surgery.Intraoperative immobilization time for the inferior tibiofibular syndesmosis,American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score,Olerud-Molander ankle function score,and visual analog scale(VAS)for pain were also compared at the last follow-up between the 2 groups.ResultsThere was no statistically significant difference in the preoperative baseline data between the 2 groups of patients,indicating comparability(P>0.05).There was no statistically significant difference between the 2 groups in intraoperative immobilization time for the inferior tibiofibular syndesmosis,disparity between the injured and normal sides in postoperative fibular translation distance,or VAS pain score at the last follow-up(P>0.05).The anterior and posterior syndesmotic distances,disparity between the injured and normal sides in fibular rotation angle,AOFAS ankle-hindfoot score,and Olerus-Molander ankle function score in the observation group[0.1(-0.2,0.3)mm,0.1(-0.3,0.5)mm,-0.5(-1.1,0.8)°,96(93,100)points,and 95(90,100)points]were all significantly better than those in the control group[1.4(0.6,2.1)mm,1.5(0.9,2.2)mm,1.2(-3.8,3.7)°,93(89,96)points,and 90(85,100)points](all P<0.0

关 键 词：踝损伤 韧带 关节 骨折固定术 内 骨钉 环抱式固定 

分 类 号：R687.3[医药卫生—骨科学]