袢钢板弹性固定在踝关节骨折合并下胫腓联合损伤中的应用效果  

Application effect of elastic fixation with endobutton in ankle joint fracture complicated with lower tibiofibular joint injury

作　　者：叶永贤 诸灵祺 郭小微 陈佳滨 翟文亮 YE Yongxian;ZHU Lingqi;GUO Xiaowei;CHEN Jiabin;ZHAI Wenliang(Department of Orthopaedics,the 909th Hospital Logistic Support Forces of the Chinese People's Liberation Army Southeast Hospital Affiliated to Xiamen University,Fujian Province,Zhangzhou 363000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇九医院厦门大学附属东南医院骨科,福建漳州363000

出　　处：《中国当代医药》2025年第9期54-58,共5页China Modern Medicine

摘　　要：目的探讨袢钢板弹性固定在踝关节骨折合并下胫腓联合损伤中的临床效果。方法回顾性分析2020年1月至2023年1月厦门大学附属东南医院手术治疗的83例踝关节骨折合并下胫腓联合损伤患者的病例资料,按照手术方式的不同分为治疗组(35例)和对照组(48例)。治疗组采用袢钢板弹性固定,对照组采用皮质螺钉固定。记录两组患者手术时间、术中出血量、住院天数、术后并发症、下胫腓联合距离、下胫腓联合重叠距离、踝关节活动度、视觉模拟评分法(VAS)评分、美国矫形外科足踝协会(AOFAS)踝-后足评分系统评分。结果两组患者术中出血量、手术时间、住院天数、术后并发症总发生率比较,差异无统计学意义(P>0.05)。两组患者术后3d、术后6周的下胫腓联合距离(TFCS)、下胫腓联合重叠距离(TFO)及VAS评分比较,差异无统计学意义(P>0.05)。治疗组术后3个月、1年的TFCS小于对照组,VAS评分高于对照组,TFO大于对照组,差异有统计学意义(P<0.05)。治疗组术后3d、6周、3个月及1年AOFAS踝-后足评分系统评分高于对照组,双侧踝关节活动度差值小于对照组,差异有统计学意义(P<0.05)。结论袢钢板弹性固定下胫腓联合具有更好的复位质量、足踝功能,同时手术时间、手术出血量及术后并发症未增加,是一种值得推荐的治疗方法。Objective To investigate the clinical effect of elastic fixation with endobutton in ankle joint fracture complicated with lower tibiofibular joint injury.Methods A total of 83 patients with ankle fracture combined with lower tibiofibular in-jury were retrospectively analyzed from January 2020 to January 2023 in Southeast Hospital Affiliated to Xiamen University.They were divided into treatment group(35 cases)and control group(48 cases)according to different surgical methods.The treatment group was fixed by elastic fixation with endobutton,and the control group was fixed by cortical screw.Operation time,intraoperative blood loss,length of stay,postoperative complications,lower tibiofibular joint distance,lower tibiofibular joint overlapdistance,anklerangeofmotion,visualanaloguescale(VAS)score,andAmericanOrthopaedic FootandAnkle Association(AOFAS)ankle-posterior foot score were recorded in the two groups.Results There were no significant differences in the amount of blood loss,operation time,hospital stay and total incidence of postoperative complications between the two groups(P>0.05).There were no significant differences in tibiofibular clear space(TFCS),tibiofibular overlap(TFO)and VAS score between the two groups at 3 days and 6 weeks after surgery(P>0.05).At 3 months and 1 year after operation,TFCS,VAS score and TFO of the treatment group were lower than those of the control group,and the differences were statistically significant(P<0.05).The AOFAS ankle hind-foot score at 3 days,6 weeks,3 months and 1 year after surgery in the treat-ment group were higher than thoset in the control group,and the difference of bilateral ankle motion was smaller than that in the control group,with statistical significances(P<0.05).Conclusion Elastic fixation with endobutton of lower tibiofibular combination has better reduction quality,foot and ankle function,and no increase in operation time,operation bleeding and postoperative complications.It is a recommended treatment.

关 键 词：踝关节骨折 下胫腓联合损伤 袢钢板弹性固定 下胫腓螺钉 

分 类 号：R683[医药卫生—骨科学]