三角韧带锚钉修复联合切开复位内固定治疗踝关节骨折伴三角韧带损伤的效果  

Effect of triangular ligament anchor repair combined with open reduction and internal fixation in the treatment of ankle fracture with triangular ligament injury

作　　者：毕海峰 BI Hai-feng(Department of Orthopaedics,Zibo 148th Hospital,Zibo 255300,China)

机构地区：[1]淄博一四八医院骨科一区,255300

出　　处：《中国实用医药》2025年第5期31-35,共5页China Practical Medicine

摘　　要：目的探讨三角韧带锚钉修复联合切开复位内固定(ORIF)对踝关节骨折伴三角韧带损伤的治疗效果。方法选取踝关节骨折伴三角韧带损伤患者66例,应用随机数字表法分为对照组及观察组,每组33例。对照组行ORIF治疗,观察组在对照组的基础上联合三角韧带锚钉修复治疗。对比两组手术指标(手术时间、术中出血量、骨折愈合时间、住院时间)、视觉模拟评分法(VAS)评分、美国足与踝关节协会(AOFAS)踝-后足功能评分、患侧内踝间隙、骨代谢指标[骨碱性磷酸酶(BALP)、骨钙素(BGP)、Ⅰ型前胶原氨基端延长肽(PⅠNP)、β-胶原降解产物(β-CTX)]及并发症发生率。结果观察组手术时间(114.35±11.25)min长于对照组的(101.52±10.18)min、骨折愈合时间(13.54±2.17)周及住院时间(17.48±2.48)d短于对照组的(15.18±1.47)周、(18.84±2.18)d,有统计学差异(P<0.05);两组术中出血量对比,无统计学差异(P>0.05)。术后3个月,观察组VAS评分(1.72±1.43)分低于对照组的(2.83±1.06)分、AOFAS踝-后足功能评分(90.64±10.36)分高于对照组的(85.47±6.38)分、患侧内踝间隙(2.64±0.47)mm小于对照组的(3.47±0.49)mm,有统计学差异(P<0.05)。术后3个月,观察组BALP(127.74±13.25)U/L、BGP(7.32±1.05)μg/L、PⅠNP(128.64±13.51)μg/L高于对照组的(110.58±10.21)U/L、(5.84±1.11)μg/L、(119.05±12.62)μg/L,β-CTX(0.34±0.05)μg/L低于对照组的(0.45±0.07)μg/L,有统计学差异(P<0.05)。观察组并发症发生率6.06%低于对照组的30.30%,有统计学差异(P<0.05)。结论与单一ORIF治疗对比,联合三角韧带锚钉修复可缩短踝关节骨折伴三角韧带损伤患者的骨折愈合时间、住院时间,降低疼痛程度,缩小患侧内踝间隙,提高AOFAS踝-后足功能评分,改善骨代谢指标,降低并发症发生率。Objective To explore the therapeutic effect of triangular ligament anchor repair combined with open reduction and internal fixation(ORIF)on ankle fracture with triangular ligament injury.Methods 66 patients with ankle fracture and triangular ligament injury were selected and divided into control group and observation group according to random numerical table,with 33 cases in each group.The control group was treated with ORIF,and the observation group was treated with triangular ligament anchor repair.The surgical indexes,pain,ankle AOFAS score,medial malleolar space,bone metabolism indexes and complication rate were compared between the two groups.Both groups were compared in terms of surgical indexes(operative time,intraoperative blood loss,fracture healing time,length of hospital stay),visual analogue scale(VAS)score,American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hind foot score,medial malleolar space of the affected side,bone metabolism indexes[bone alkaline phosphatase(BALP),bone gamma-carboxyglutamic-acid-containing proteins(BGP),procollagen type 1 amino-terminal propeptide(PⅠNP),β-collagen degradation product(β-CTX)]and complication rate.Results The observation group had longer operation time of(114.35±11.25)min than(101.52±10.18)min in the control group;the fracture healing time and length of hospital stay were(13.54±2.17)weeks and(17.48±2.48)d in the observation group,which were shorter than(15.18±1.47)weeks and(18.84±2.18)d in the control group;there was statistical difference(P<0.05).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).3 months after surgery,he observation group had a lower VAS score of(1.72±1.43)points than(2.83±1.06)points in the control group,a higher AOFAS ankle-hind foot score of(90.64±10.36)points than(85.47±6.38)points in the control group,and a lower medial malleolar space of the affected side of(2.64±0.47)mm than(3.47±0.49)mm in the control group.There was statistical difference(P<0.05).3 months after surgery,t

关 键 词：三角韧带锚钉修复 踝关节骨折 三角韧带损伤 切开复位内固定 患侧内踝间隙 

分 类 号：R68[医药卫生—骨科学]