Objective To investigate the efficacy of direct vision precise reduction in the treatment of lower tibiofibular syndesmosis injury by comparing with closed reduction method.Methods The clinical data of 60 patients with ankle fracture and lower tibiofibular syndesmosis injury admitted to our hospital from June 2020 to June 2023 were retrospectively analyzed.Among them,30 cases were treated with closed reduction fixation(closed group)and 30 cases were treated with precise reduction of lower tibiofibular syndesmosis with reference to anatomic markers under direct vision(direct vision group).The age,sex,injury mechanism,operation time,volume of intraoperative blood loss,number of fluoroscopy,tibiofibular bottom clearance(TBCS),tibiofibular overlap(TBOL),American Orthopaedic Foot and Ankle Society(AOFAS)Ankle-posterior foot score,excellent and good rate and complication rate were compared between the two groups.Results In the closed group,the operative time,intraoperative blood loss and fluoroscopy times were(18.23±0.58)min,(84.37±1.83)mL and(9.47±0.26)times,while those in the direct vision group were(16.00±0.55)min,(74.5±1.61)mL and(7.97±0.23)times,respectively;there were significant differences in above indexes between the two groups(P＜0.05).There was no significance in preoperative TBCS,TBOL and other indicators between the two groups(P＞0.05);after surgery,the TBCS and TBOL in the closed group was(3.16±0.04)mm and(7.77±0.03)mm,and those in the open group was(2.98±0.05)mm and(7.92±0.04)mm,respectively(P＜0.05).The excellent and good rate of the open vision group was significantly higher than that of the closed group(96.70％vs 73.30％,P＜0.05).The incidence of complications in the direct vision group was significantly lower than that in the closed group(6.7％vs 26.70％,P＜0.05).Conclusion Precise reduction of lower tibiofibular combined with dislocation under direct vision is effective in the treatment of lower tibiofibular combined injury,which can significantly shorten the operation time,reduce fluoroscopy times,and improve the prognosis of patients.
关键词
下胫腓联合损伤/闭合复位/直视下精准复位/复位不良
Key words
lower tibiofibular joint injury/closed reduction/accurate reduction under direct vision/poor reduction
维普
万方数据