空心加压螺钉与防滑钢板内固定治疗Lauge-Hansen旋后外旋型Ⅳ度踝关节骨折的临床效果比较  

Comparison of the Clinical Effects of Lauge-Hansen Supination-external Rotation TypeⅣAnkle Fracture Treated with Hollow Compression Screw and Anti-skip Plate Internal Fixation

作　　者：洪钱 胡军[1] 周迎光[1] HONG Qian;HU Jun;ZHOU Yingguang(Lianyungang Hospital of TCM(Lianyungang Affiliated Hospital of Nanjing University of Chinese Medicine),Lianyungang 222000,Jiangsu,China)

机构地区：[1]连云港市中医院(南京中医药大学连云港附属医院),江苏连云港222000

出　　处：《世界复合医学(中英文)》2025年第1期14-18,共5页World Journal of Complex Medicine

摘　　要：目的比较空心加压螺钉与防滑钢板内固定治疗Lauge-Hansen旋后外旋型Ⅳ度踝关节骨折患者的效果。方法根据固定方式不同,将回顾性选取2019年6月—2022年6月连云港市中医院接诊的96例Lauge-Hansen旋后外旋型Ⅳ度踝关节骨折患者的临床资料分为两组。对照组(n=52)予以空心加压螺钉固定后踝骨折块,治疗组(n=44)予以防滑钢板固定后踝骨折块,比较两组术中与术后指标、视觉模拟评分法(Visual Analogue Scale,VAS)评分、踝关节评分与术后并发症发生情况。结果组间手术时间、术中出血量、并发症发生率比较,差异均无统计学意义(P均>0.05)。治疗组骨痂形成时间、骨折愈合时间相比于对照组更短,差异均有统计学意义(P均<0.05)。术后3个月,治疗组VAS评分为(2.64±0.35)分,低于对照组的(4.16±0.82)分,差异有统计学意义(t=11.439,P<0.05)。术后3个月,治疗组Baird-Jackson踝关节功能量表评分相比于对照组更高,差异有统计学意义(P<0.05)。结论Lauge-Hansen旋后外旋型Ⅳ度踝关节骨折属于关节内骨折,后踝骨块的复位及固定显得尤其重要,防滑钢板内固定较空心加压螺钉内固定具有更好的稳定性,能在短时间内促进患者康复,改善踝关节功能。Objective To compared the effect of hollow compression screw and anti-skid plate internal fixation in the treatment of patients with Lauge-Hansen supination-external rotation typeⅣankle fracture.Methods According to different fixation methods,the clinical data of 96 patients with Lauge-Hansen supination-external rotation typeⅣankle fracture admitted to Lianyungang Hospital of TCM from June 2019 to June 2022 were retrospectively selected and divided into two groups.The control group(n=52)was treated with hollow compression screws to fix the posterior malleolus fracture block,and the treatment group(n=44)was treated with anti-skid plate to fix the posterior malleolus fracture block.The intraoperative and postoperative indicators,Visual Analogue Scale(VAS)score,ankle score and postoperative complications were compared between the two groups.Results There were no significant differences in operation time,intraoperative blood loss and complication rate between two groups(all P>0.05).Compared with the control group,the callus formation time and fracture healing time in the treatment group were shorter,and the differences were statistically significant(both P<0.05).Three months after operation,the VAS score in the treatment group was(2.64±0.35)points,which was lower than(4.16±0.82)points in the control group,and the difference was statistically significant(t=11.439,P<0.05).Three months after operation,Compared with the control group,the Baird-Jackson Ankle Joint Function Scale score of the treatment group was higher,and the difference was statistically significant(P<0.05).Conclusion Lauge-Hansen supination-external rotation typeⅣankle fracture belongs to intra-articular fracture.The reduction and fixation of posterior malleolus bone block is particularly important.Anti-skid plate internal fixation has better stability than hollow compression screw internal fixation,which can promote the rehabilitation of patients in a short time and improve the ankle function.

关 键 词：空心加压螺钉 防滑钢板 Lauge-Hansen旋后外旋型 Ⅳ度踝关节骨折 踝关节评分 

分 类 号：R687.3[医药卫生—骨科学]