硬纸夹板外固定系统治疗旋后外旋型踝关节骨折的疗效评价  

Evaluation of the Efficacy of the Cardboard Splint External Fixation System in Treating Ankle Fractures of Supination-External Rotation

作　　者：戴禹润 郑移兵[1] 齐越峰[1] 李晔[1] 倪前伟[1] 董延旭[1] 金立昆[1] 张杰[1] 张海群[1] 侯云杰 DAI Yurun;ZHENG Yibing;QI Yuefeng;LI Ye;NI Qianwei;DONG Yanxu;JIN Likun;ZHANG Jie;ZHANG Haiqun;HOU Yunjie(Beijing Fengsheng Traditional Chinese Medicine Orthopedic Hospital,Beijing 100033,China)

机构地区：[1]北京市丰盛中医骨伤专科医院,北京100039

出　　处：《中国中医骨伤科杂志》2025年第2期34-38,44,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：北京市西城区科技新星项目(XWKX2022-05)。

摘　　要：目的:评价硬纸夹板外固定系统对于Ⅱ度及以上旋后外旋型踝关节骨折固定的有效性与安全性。方法:选取2021年11月至2023年6月就诊的62例旋后外旋型踝关节骨折患者,随机分为观察组和对照组,分别采用硬纸夹板(观察组)和U形高分子石膏(对照组)固定。对比两组患者首次复位后及达到临床愈合时骨折移位的变化情况,比较两组患者骨折临床愈合时间及疼痛评分,将压疮的发生情况作为安全性指标。结果:62例旋后外旋型踝关节骨折患者,首次复位均达到“优”“良”的复位效果,复位前后对比差异有统计学意义(P<0.05);最终观察组与对照组所有病例均维持了“优”“良”的复位效果,组间对比差异无统计学意义(P>0.05)。观察组达到临床愈合时间平均为(43.8±12.5)d,对照组为(51.3±13.1)d,两组数据组间对比差异有统计学意义(P<0.05)。骨折复位前及固定1周后两组患者VAS评分差异无统计学意义(P>0.05);固定2周后观察组疼痛评分更低,差异有统计学意义(P<0.05)。两组患者在外固定保守治疗过程中均未出现压疮。结论:两种外固定方式对旋后外旋型踝关节骨折的治疗均安全有效,硬纸夹板在疼痛控制方面具有一定的优势。相较U形石膏外固定,硬纸夹板外固定可能更有利于踝关节骨折愈合。Objective:To evaluate the efficacy of the cardboard splint external fixation system for the fixation of ankle fractures of supination-external rotation typeⅡ~Ⅳ.Methods:62 patients with SERⅡankle fractures who attended from November 2021 to June 2023 were selected.They were randomly divided into the observation group and the control group and were fixed with cardboard splint and U-shaped polymeric plaster,respectively.We compared the fracture displacement after the initial reduction and that after clinical healing.The time of clinical healing and pain score between the two groups were compared.The occurrence of pressure ulcers was taken as a safety indicator.Results:All 62 patients with SERⅡankle fractures achieved excellent and good results at initial reduction,and the comparison between before and after reduction was statistically significant(P<0.05).Finally,all the cases in the observation group and the control group maintained the excellent and good reduction,and there was no statistical significance in the comparison between the groups(P>0.05).The average time to clinical healing was(43.8±12.5)d in the observation group and(51.3±13.1)d in the control group.The comparison of statistics between the two groups was of statistical significance(P<0.05).There was no statistical significance in the VAS scores of the two groups of patients before fracture reduction and at 1 week of immobilization(P>0.05).The pain scores were lower in the observation group at 2 weeks of immobilization,and the difference was statistically significant,with the pain in the observation group being lower than that in the control group(P<0.05).There were no pressure sores in the two groups during the conservative treatment of external fixation.Conclusion:Both external fixation methods are safe and effective in the treatment of supinated externally rotated ankle fractures,and the cardboard splint fixation has certain advantages in terms of pain control.External fixation with cardboard splint may be more conducive to fracture healing

关 键 词：踝关节骨折 旋后外旋型 保守治疗 硬纸夹板 石膏 

分 类 号：R683.42[医药卫生—骨科学]