经腓骨入路与腓骨后外侧入路在旋后外旋型Ⅳ度踝关节骨折患者治疗中的应用效果分析  

Comparative Analysis of Transfibular Approach versus Trans-Posterolateral Approach in the Treatment of Supination-External Rotation Stage IV Ankle Fractures

作　　者：张祥宇 徐伟 王自鸿 孙策勇 王路军 ZHANG Xiangyu;XU Wei;WANG Zihong;SUN Ceyong;WANG Lujun(Department of Orthopedics,Beijing Huairou Hospital,Beijing 101499,China)

机构地区：[1]北京怀柔医院骨科,北京101499

出　　处：《延边大学医学学报》2025年第2期62-64,共3页Journal of Medical Science Yanbian University

摘　　要：目的:探究经腓骨入路(TA)与腓骨后外侧入路(TPA)在旋后外旋型Ⅳ度踝关节骨折(AF)患者治疗中的应用效果及安全性。方法:选取2021年6月—2023年8月北京怀柔医院收治的行钢板螺钉内固定术旋后外旋型Ⅳ度AF患者152例作为研究对象,按照手术入路方式的不同分为TA组和TPA组,分组中应用倾向性评分匹配法匹配,每组76例。比较两组患者临床指标、术后6个月踝关节活动度、骨折愈合情况。结果:TPA组术中出血量、手术时间、住院时间、骨折愈合时间均优于TA组(P <0.05);术后6个月,TPA组踝关节伸、屈、旋前、旋后活动度均大于TA组(P <0.05);TPA组骨折愈合优良率高于TA组(P <0.05)。结论:相比TA内固定术,TPA内固定术治疗旋后外旋型Ⅳ度AF疗效更好,可加快术后康复和骨折愈合,有效恢复踝关节活动度。Objective:To compare the efficacy and safety of the transfibular approach(TA)and trans-posterolateral approach(TPA)in the treatment of supination-external rotation stage IV ankle fractures(AF).Methods:Patients with stage IV AF treated with plate-screw fixation at Beijing Huairou Hospital from June 2021 to August 2023 were enrolled.Participants were divided into TA and TPA groups via propensity score matching,with 76 cases in each group.Clinical parameters,ankle range of motion(ROM)at 6 months postoperatively,and fracture healing outcomes were compared.Results:The TPA group demonstrated significantly better outcomes in intraoperative blood loss,operative time,hospital stay,and fracture healing time compared to the TA group(P<0.05).At 6-month follow-up,the TPA group exhibited greater ROM in ankle dorsiflexion,plantarflexion,pronation,and supination(P<0.05).Additionally,the TPA group achieved a higher excellent-good rate of fracture healing(P<0.05).Conclusion:Compared to TA,TPA internal fixation yields superior clinical outcomes for stage IVAF,facilitating accelerated postoperative recovery,enhanced fracture union,and improved restoration of ankle mobility.

关 键 词：旋后外旋型Ⅳ度踝关节骨折 经腓骨入路内固定术 腓骨后外侧入路内固定术 

分 类 号：R683[医药卫生—骨科学]