| 孙舒雅,尹 宏,孙 欣,蔡 斌,朱 敏.后外侧与后内侧入路内固定术治疗旋后外旋型Ⅳ度踝关节骨折的回顾性对照研究[J].,2022,(24):4742-4746 |
| 后外侧与后内侧入路内固定术治疗旋后外旋型Ⅳ度踝关节骨折的回顾性对照研究 |
| Retrospective Controlled Study of Posterolateral and Posteromedial Approaches Internal Fixation in the Treatment of Supination and External Rotation Type IV Degree Ankle Fracture |
| 投稿时间：2022-05-29 修订日期：2022-06-24 |
| DOI：10.13241/j.cnki.pmb.2022.24.028 |
| 中文关键词: 后外侧 后内侧 钢板螺钉内固定术 旋后外旋型Ⅳ度 踝关节骨折 |
| 英文关键词: Posterolateral Posteromedial Plate screw internal fixation Supination and external rotation type IV degree Ankle fracture |
| 基金项目:江苏省社会发展基金资助项目（BE20180791） |
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| 中文摘要: |
| 摘要 目的：对比后外侧与后内侧入路内固定术治疗旋后外旋型Ⅳ度踝关节骨折治疗效果。方法：回顾性分析2019年5月-2021年5月于本院治疗的89例旋后外旋型Ⅳ度踝关节骨折患者的临床资料，按照钢板螺钉内固定术入路不同手术入路分组，其中41例手术入路为后内侧入路（对照组），48例手术入路为后外侧入路（观察组）。对照组中男24例，女17例，年龄23～65岁，平均（39.88±9.36）岁；患侧：左侧23例，右侧18例，受伤原因：交通事故26例，高处坠落15例。观察组中男27例，女21例，年龄22～67岁，平均（41.47±9.27）岁，患侧：左侧28例，右侧20例，受伤原因：交通事故32例，高处坠落16例。对比术后6个月两组骨折愈合情况、手术指标、踝关节功能、生活质量以及并发症情况。结果：观察组骨折愈合优良率为95.83%，明显高于对照组80.49%（P＜0.05）；与对照组比较，观察组术中出血量较少，手术时间、骨折愈合时间及住院时间均较短（P＜0.05）；术前两组踝关节功能及健康状况调查简表（SF-36）无差异（P>0.05），术后踝关节功能、生活质量均提高，而观察组术后踝-后足功能、Mazur（踝关节症状和功能）评分、SF-36评分均高于对照组（P＜0.05）；观察组并发症总发生率为4.16%，明显低于对照组17.07%（P＜0.05）。结论：后外侧入路较后内侧入路钢板螺钉内固定术治疗旋后外旋型Ⅳ度踝关节骨折的疗效更佳，可提高骨折愈合率、踝关节功能和生活质量，并有助于降低术后并发症发生率。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the therapeutic effect of posterolateral and posteromedial approaches internal fixation in the treatment of supination and external rotation type Ⅳ degree ankle fracture. Methods: The clinical data of 89 patients with supination and external rotation type IV degree ankle fracture who were treated in our hospital from May 2019 to May 2021 were retrospectively analyzed. They were grouped according to different surgical approaches of plate screw internal fixation, including 41 cases of posteromedial approach (control group), and 48 cases of posterolateral approach (observation group). In the control group, there were 24 males and 17 females, aged from 23 to 65 years, with an average of (39.88±9.36) years. Affected side: 23 cases on the left, and 18 cases on the right. Causes of injury: 26 cases of traffic accidents, and 15 cases of falling from height. In the observation group, there were 27 males and 21 females, aged from 22 to 67 years, with an average of (41.47±9.27) years. Affected side: 28 cases on the left, and 20 cases on the right. Causes of injury: 32 cases of traffic accidents, and 16 cases of falling from height. The fracture healing, operation indexes, ankle function, quality of life and complications were compared between the two groups at 6 months after operation. Results: The excellent and good rate of fracture healing in the observation group was 95.83%, which was significantly higher than 80.49% in the control group (P＜0.05). Compared with the control group, the observation group had less intraoperative blood loss, shorter operation time, fracture healing time and hospitalization time (P＜0.05). There were no differences in ankle function and Short-Form-36 health survey (SF-36) between the two groups before operation (P>0.05). The ankle function and quality of life were improved after operation, while the ankle hindfoot function, Mazur (ankle symptoms and function) score and SF-36 score of the observation group were higher than those of the control group (P＜0.05). The total incidence of complications in the observation group was 4.16%, which was significantly lower than 17.07% in the control group (P＜0.05). Conclusion: The posterolateral approach is more effective than posteromedial approach in the treatment of supination and external rotation type Ⅳ degree ankle fracture. It can improve the fracture healing rate, ankle function and quality of life, and help to reduce the incidence of postoperative complications. |
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