两种固定治疗踝关节骨折合并下胫腓联合韧带损伤的疗效比较  

Efficacy Comparison Between Two Fixation Methods in the Treatment of Ankle Fracture Combined with Distal Tibiofibular Syndesmosis Injury

作　　者：王驭恺 吴升辉 龚子凌 诸葛英杰 梅炯[1] Wang Yukai;Wu Shenghui;Gong Ziling;Zhuge Yingjie;Mei Jiong(Department of Orthopedics,Shanghai Sixth People's Hospital,Shanghai 200233,China)

机构地区：[1]上海市第六人民医院骨科,上海200233

出　　处：《成都医学院学报》2025年第2期217-220,共4页Journal of Chengdu Medical College

基　　金：国家自然科学基金项目(No:12172224)。

摘　　要：目的 对比Endobutton带袢钢板弹性固定与下胫腓螺钉刚性固定治疗踝关节骨折(AF)合并下胫腓联合韧带损伤患者的临床疗效。方法 选择2019年10月至2023年6月上海市第六人民医院收治的AF合并下胫腓联合韧带损伤患者100例为研究对象,根据治疗方法不同分为A组(46例)和B组(54例),A组给予下胫腓螺钉刚性固定,B组给予Endobutton带袢钢板弹性固定。比较两组患者手术情况、负重时间、胫腓联合间隙(TBCS)、胫腓骨重叠(TFO)情况、术后6个月临床疗效及并发症发生率。结果 术后B组部分负重时间、完全负重时间较A组短(P<0.05)。术后两组患者TBCS小于术前(P<0.05),TFO大于术前(P<0.05);但术后两组患者TBCS和TFO比较,差异均无统计学意义(P>0.05)。术后6个月B组患者临床疗效优良率83.33%高于A组65.22%(P<0.05),B组患者并发症总发生率1.85%低于A组15.22%(P<0.05)。结论 与下胫腓螺钉刚性固定相较,Endobutton带袢钢板弹性固定能缩短AF合并下胫腓联合韧带损伤患者负重时间,提高术后6个月临床疗效,减少并发症发生率。Objective To compare the clinical efficacy between endobutton flexible fixation and screw rigid fixation in the treatment of ankle fracture(AF)combined with distal tibiofibular syndesmosis injury.Methods A total of 100 patients with AF combined with distal tibiofibular syndesmosis injury admitted to Shanghai Sixth People's Hospital from October 2019 to June 2023 were selected as the study objects.They were divided into two groups according to different treatment methods:group A(distal tibiofibular screw rigid fixation,n=46)and group B(endobutton flexible fixation,n=54).The surgical conditions,weight-bearing time,tibiofibular clear space(TBCS),tibio fibular overlap(TFO),clinical efficacy at 6 months after surgery,and incidence of complications were compared between the two groups.Results The partial weight-bearing time and full weight-bearing time in group B were shorter than those in group A(P<0.05).After surgery,the TBCS decreased while the TFO increased in both groups compared with those before surgery(P<0.05),but there was no significant difference between the two groups(P>0.05).The excellent and good rate in group B at 6 months after surgery was 83.33%,which was higher than 65.22%in group A(P<0.05).The total incidence of complications was 1.85%in group B,which was lower than 15.22%in group A(P<0.05).Conclusion Compared with distal tibiofibular screw rigid fixation,endobutton flexible fixation can shorten the weight-bearing time of patients with AF combined with distal tibiofibular syndesmosis injury,improve the 6-month postoperative clinical efficacy,and reduce the incidence of complications.

关 键 词：踝关节骨折 韧带损伤 Endobutton带袢钢板弹性固定 下胫腓螺钉刚性固定 疗效 

分 类 号：R687.3[医药卫生—骨科学]