切开复位内固定术联合韧带修复治疗踝关节骨折合并下胫腓前韧带断裂的疗效分析  

Analysis of the efficacy and prognosis of open reduction and internal fixation combined with ligament repair for the treatment of ankle fracture combined with anterior tibiofibular ligament rupture

作　　者：李林[1] 陈楚鹰 何久圣 张浩 LI Lin;CHEN Chuying;HE Jiusheng;ZHANG Hao(Department of Orthopedics Ⅱ,Shunyi District Hospital,Beijing 101300,China)

机构地区：[1]北京市顺义区医院骨二科,101300

出　　处：《临床外科杂志》2025年第1期105-108,共4页Journal of Clinical Surgery

摘　　要：目的探讨切开复位内固定术联合韧带修复治疗踝关节骨折合并下胫腓前韧带断裂的疗效。方法2020年1月~2022年8月收治的踝关节骨折合并下胫腓前韧带断裂病人92例,按治疗方式不同分为研究组(46例)和对照组(46例)。对照组行切开复位内固定术治疗,研究组行切开复位内固定术联合韧带修复治疗,比较两组手术指标与恢复情况、疼痛程度(VAS评分)、踝关节功能恢复(AOFAS评分、踝关节ROM)、骨代谢指标、术后并发症与远期预后的差异。结果与对照组比较,研究组手术时间更长,住院时间、骨折愈合时间更短,差异有统计学意义(P<0.05)。重复测量显示,VAS评分的时点效应、组间效应、交互效应比较,差异均有统计学意义(P<0.05),与术前相比,术后1个月、术后3个月,两组VAS评分均降低,研究组优于对照组,两组比较差异有统计学意义(P<0.05)。与术前相比,术后6个月,两组AOFAS评分、踝关节ROM均升高,研究组高于对照组,两组比较差异有统计学意义(P<0.05)。与术前相比,术后6个月,两组胶原Ⅰ型N末端肽(PINP)、骨钙素(BGP)、骨碱性磷酸酶(BALP)均升高,β胶原降解产物(β-CTX)水平均降低(P<0.05),且研究组优于对照组,两组比较差异有统计学意义(P<0.05)。两组术后并发症比较,差异无统计学意义(P>0.05),研究组远期预后更好,两组比较差异有统计学意义(P<0.05)。结论切开复位内固定术联合韧带修复治疗踝关节骨折合并下胫腓前韧带断裂,可有效降低疼痛程度,改善踝关节功能,调节骨代谢水平,促进骨折愈合,且安全性与远期预后较好。Objective Exploring the efficacy and prognostic analysis of open reduction and internal fixation combined with ligament repair in the treatment of ankle joint fractures with anterior tibiofibular ligament rupture.Methods Ninety-two patients with ankle fracture combined with lower tibiofibular anterior ligament rupture admitted to our hospital from January 2020 to August 2022 were selected to implement the prospective study,and they were divided into 46 cases in the study group and 46 cases in the control group according to the different treatment modalities.The control group only received open reduction and internal fixation surgery,while the research group received open reduction and internal fixation surgery combined with ligament repair treatment.The differences in surgical indicators and recovery,pain level(VAS score),ankle joint function recovery(AOFAS score,ankle ROM),bone metabolism indicators,postoperative complications,and long-term prognosis between the two groups were compared.Results Compared with the control group,the study group had longer operation time,shorter hospitalization time,and shorter fracture healing time(P<0.05).Repeated measures showed that there were differences in the comparison of time-point effects,between-group effects,and interaction effects of VAS scores(P<0.05),and VAS scores were lower in both groups at 1 month and 3 months postoperatively compared with preoperatively,and were better in the study group than in the control group(P<0.05).Compared with preoperative,AOFAS score and ankle ROM were increased in both groups at 6 months postoperatively,and the study group was better than the control group(P<0.05).Compared with preoperative,collagen typeⅠN-terminal peptide(PINP),osteocalcin(BGP),bone alkaline phosphatase(BALP)were elevated in both groups at 6 months postoperatively,and the level ofβ-collagen degradation product(β-CTX)β-CTX was reduced in the former(P<0.05);and the study group was better than the control group(P<0.05).Compared with the control group,there was no sig

关 键 词：踝关节骨折 下胫腓前韧带断裂 切开复位内固定术 韧带修复 疗效 预后 

分 类 号：R687.3[医药卫生—骨科学]