钛缆等张环治疗下胫腓联合损伤的疗效分析  

Titanium cable tensioning ring fixation for distal tibiofibular syndesmosis injury

作　　者：孙建林 杨佐明[2] 王斌[2] 赵小明[2] 赵泉勇[2] 李孟艳 李鑫 Sun Jianlin;Yang Zuoming;Wang Bin;Zhao Xiaoming;Zhao Quanyong;Li Mengyan;Li Xin(North China University of Science and Technology,Tangshan 063000,China;The Second Hospital of Tangshan,Tangshan 063000,China)

机构地区：[1]华北理工大学,唐山063000 [2]唐山市第二医院,唐山063000

出　　处：《中华创伤骨科杂志》2024年第10期858-864,共7页Chinese Journal of Orthopaedic Trauma

基　　金：河北省医学科学研究课题(20240657);唐山市人才资助项目(C202303033)

摘　　要：目的评价钛缆等张环水平面环扎固定治疗下胫腓联合(DTS)损伤的疗效。方法回顾性分析2021年1月至2023年1月唐山市第二医院创伤科采用手术治疗的108例DTS损伤患者临床资料。男68例, 女40例;年龄(40.1±13.0)岁。根据内固定方式不同分为钛缆组(53例, 采用钛缆等张环水平面环扎固定)和带袢钢板组(55例, 采用带袢钢板固定), 比较两组患者的术后1周内、12个月横断位CT片的下胫腓前、后间隙, 以及术后6、12个月Baird-Jackson踝关节功能评分。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。术后1周内两组患者下胫腓前、后间隙比较, 差异均无统计学意义(P>0.05)。术后12个月带袢钢板组患者下胫腓前、后间隙[(3.60±0.59)、4.58(4.38,4.89)mm]均大于钛缆组患者[(3.34±0.53)、4.36(4.13,4.67)mm], 差异均有统计学意义(P<0.05)。两组患者术后6、12个月Baird-Jackson踝关节功能评分比较, 差异无统计学意义(P>0.05)。结论钛缆等张环治疗DTS损伤的临床效果与带袢钢板相似, 但在手术操作以及避免远期复位丢失等方面可能具有一定的优越性。Objective To evaluate the titanium cable tensioning ring fixation in the treatment of distal tibiofibular syndesmosis(DTS)injury.Methods A retrospective study was conducted to analyze the 108 patients with DTS injury who had undergone surgical treatment from January 2021 to January 2023 at Department of Traumatology,The Second Hospital of Tangshan.There were 68 males and 40 females with an age of(40.1±13.0)years.According to the fixation methods used,the patients were divided into a Titanium cable group and an Endobutton plate group.The Titanium cable group of 53 cases was subjected to fixation with a titanium cable tensioning ring while the Endobutton plate group of 55 cases to fixation with an Endobutton plate.The 2 groups were compared in terms of the anterior and posterior tibiofibular spaces on the transverse CT images at 1 week and 12 months postoperatively,as well as the Baird-Jackson scores of ankle joint function at 6 and 12 months postoperatively.Results There was no statistically significant difference in the preoperative general data between the 2 groups,indicating comparability(P>0.05).There was no statistically significant difference in the comparison of the anterior and posterior tibiofibular spaces on the transverse CT images at 1 week postoperatively(P>0.05).The anterior and posterior tibiofibular spaces on the transverse CT images at 12 months postoperatively in the Endobutton plate group[(3.60±0.59)mm and 4.58(4.38,4.89)mm]were significantly greater than those in the Titanium cable group[(3.34±0.53)mm and 4.36(4.13,4.67)mm](P<0.05).There was no statistically significant difference in the Baird-Jackson ankle function scores at 6 and 12 months postoperatively between the 2 groups(P>0.05).Conclusions In the treatment of DTS injury,fixation with titanium cable tensioning ring can achieve as good therapeutic effects as fixation with Endobutton plate.However,the former may have certain advantages in surgical operation and long-term reduction loss.

关 键 词：踝关节 创伤和损伤 骨折固定术 内 下胫腓联合 

分 类 号：R687.3[医药卫生—骨科学]