经腓骨后外侧入路内固定术对旋后外旋型踝关节骨折患者骨折愈合和踝关节功能的影响  

Influences of posterolateral fibular approach internal fixation on fracture healing and ankle joint function in patients with supination-external rotation ankle fractures

作　　者：古世伟 GU Shiwei(Jiangyou People's Hospital,Mianyang 621700,Sichuan,China)

机构地区：[1]江油市人民医院,四川绵阳621700

出　　处：《中南医学科学杂志》2025年第2期280-283,共4页Medical Science Journal of Central South China

基　　金：四川省医学会骨科专项科研项目(2022SAT09)。

摘　　要：目的 探究经腓骨后外侧入路内固定术对旋后外旋型踝关节骨折患者骨折愈合和踝关节功能的影响。方法 将本院旋后外旋型踝关节骨折患者164例分为后外侧入路组(79例)和传统入路组(85例)。后外侧入路组采用经腓骨后外侧入路内固定术治疗,传统入路组采用经腓骨入路内固定术治疗。比较两组手术及骨折愈合情况、术后并发症发生情况,以及术前、术后6个月时的踝关节功能[美国足踝矫形学会评分(AOFAS)、Olerud-Molander踝关节骨折功能评分(OMAS)]和踝关节活动度参数。结果 后外侧入路组住院时间、手术时间、骨折愈合时间均短于传统入路组(P<0.05),术中出血量少于传统入路组(P<0.05)、术后并发症发生率低于传统入路组(P<0.05)。术后6个月时,两组AOFAS、OMAS量表评分均较术前升高,且后外侧入路组高于传统入路组(P<0.05);后外侧入路组踝关节伸、屈、旋前和旋后活动度均大于传统入路组(P<0.05)。结论 经腓骨后外侧入路内固定术不仅能够减少手术创伤和术后并发症,还能有效促进骨折愈合和踝关节功能的恢复。Aim To explore the influences of posterolateral fibular approach internal fixation on fracture healing and ankle joint function in patients with supination-external rotation ankle fractures.Methods A total of 164 patients with supination-external rotation ankle fractures in the hospital were selected and divided into a posterolateral approach group(79 cases) and a traditional approach group(85 cases).The posterolateral approach group underwent the posterolateral fibular approach internal fixation,while the traditional approach group underwent internal fixation via the fibular approach.The surgical and fracture healing conditions,postoperative complications,and ankle joint function [American orthopedic foot and ankle society(AOFAS),Olerud-Molander ankle score(OMAS)] and ankle joint mobility parameters before and 6 months after surgery were compared between the two groups.Results The posterolateral approach group had shorter hospitalization time,surgical time,and fracture healing time compared with the traditional approach group(P<0.05).The intraoperative bleeding volume was less than that of the traditional approach group(P<0.05),and the incidence of postoperative complications was lower than that of the traditional approach group(P<0.05).At 6 months after surgery,the AOFAS and OMAS scores in both groups were increased compared with the preoperative levels,and the posterolateral approach group was higher than the traditional approach group(P<0.05);The ankle joint extension,flexion,pronation,and supination range of motion in the posterolateral approach group were all greater than those in the traditional approach group(P<0.05).Conclusion Posterolateral fibular approach internal fixation can not only reduce surgical trauma and postoperative complications but also effectively promote fracture healing and the recovery of ankle joint function.

关 键 词：经腓骨后外侧入路内固定术 旋后外旋型踝关节骨折 骨折愈合 踝关节功能 

分 类 号：R683.42[医药卫生—骨科学]