不同固定术式治疗Haraguchi Ⅰ型后踝骨折的临床疗效比较  

Comparison of clinical efficacy of different fixation techniques for Haraguchi type I posterior ankle fracture

作　　者：李静[1] 周羿辰 郭子刚 衡德忠[1] LI Jing;ZHOU Yichen;GUO Zigang;HENG Dezhong(Department 1st of Orthopedics,the Yellow River Sanmenxia Hospital,Sanmenxia 472000,Henan,China)

机构地区：[1]黄河三门峡医院骨科一区,河南三门峡472000

出　　处：《中南医学科学杂志》2025年第1期78-81,共4页Medical Science Journal of Central South China

基　　金：河南省医学科技攻关计划项目(LHGJ20230950)。

摘　　要：目的比较HaraguchiⅠ型后踝骨折采取3种不同固定术治疗的疗效。方法选取HaraguchiⅠ型后踝骨折患者90例,根据治疗方法的不同均分为拉力螺钉组、空心钉组和钢板组。比较3组手术时间、骨折愈合时间、术后下地负重时间、术后Burwell-Charnley放射学评分、术后3个月及末次随访美国足踝外科协会(AOFAS)评分、下肢力线股胫角(FTA)及并发症情况。结果与拉力螺钉组比较,空心钉组、钢板组手术时间延长,下地负重时间和骨愈合时间缩短;且钢板组较空心钉组更为显著(P<0.05)。与同时间拉力螺钉组比较,空心钉组、钢板组AOFAS评分升高,且钢板组高于空心钉组(P<0.05)。与术前比较,术后各组FTA均降低,且钢板组<空心钉组<拉力螺钉组(P<0.05)。各组术后复位优良率钢板组>空心钉组>拉力螺钉组(P<0.05)。钢板组并发症总发生率低于空心钉组和拉力螺钉组(P<0.05)。结论3种治疗方法均能有效治疗HaraguchiⅠ型后踝骨折,但钢板组表现出更显著优势,值得临床进一步推广。Aim To explore the therapeutic effects of three different fixation techniques for Haraguchi type I posterior ankle fractures.Methods 90 patients with Haraguchi type I posterior ankle fractures were selected and divided into three groups based on different treatment methods,namely tension screw group,hollow screw group,and steel plate group.The surgical time,fracture healing time,postoperative weight-bearing time,postoperative Burwell Charnley radiological score,AOFAS score at 3 months and last follow-up,lower limb force line femur tibial angle(FTA),and complications among 3 groups were compared.Results Compared with the tension screw group,the hollow screw group and steel plate group had longer surgical time,shorter underground weight-bearing time,and shorter bone healing time;And the steel plate group was more significant than the hollow nail group(P<0.05).Compared with the group of tension screws at the same time,the American association of foot and ankle surgeons(AOFAS)scores of the hollow nail group and the steel plate group increased,and the steel plate group was higher than the hollow nail group(P<0.05).Compared with preoperative results,postoperative FTA decreased in all groups,following an order of steel plate group<hollow screw group<tension screw group(P<0.05).The excellent rate of postoperative reduction in each group was higher in the steel plate group than the hollow screw group and the tension screw group(P<0.05).The total incidence of complications in the steel plate group was lower than that in the hollow screw group and the tension screw group(P<0.05).Conclusion All three treatment methods can effectively treat Haraguchi type I posterior ankle fractures,but the steel plate group showed more significant advantages,which is worthy of further clinical promotion.

关 键 词：拉力螺钉 空心钉 支撑钢板内固定术 HaraguchiⅠ型后踝骨折 

分 类 号：R683.42[医药卫生—骨科学]