踝关节骨折合并下胫腓联合不稳内固定术中应用带袢钛板、下胫腓螺钉的对比研究
Clinical comparative study of titanium plate with loop and lower tibiofibular screw during fixation for ankle fractures with lower tibiofibular syndesmosis instability
王红英 1段连杰 1杨涵2
作者信息
- 1. 开封市第二中医院足踝外科,河南开封 475000
- 2. 开封市第二中医院外科,河南开封 475000
- 折叠
摘要
目的 对比分析踝关节骨折合并下胫腓联合不稳固定术中应用带袢钛板、下胫腓螺钉的临床效果.方法 回顾性分析2020年1月-2022年12月收治的82例踝关节骨折合并下胫腓联合不稳行切开固定术患者的病例资料,将采用下胫腓螺钉固定的38例纳入对照组,将采用带袢钛板固定的44例纳入观察组,两组患者术后均随访3个月.比较两组手术时间、术中出血量、住院天数,术后即刻与术后3个月下胫腓间隙(TFCS)、胫腓重叠距离(TFOL),术后1周与术后3个月踝关节活动度(跖屈活动度、背伸活动度)、踝关节功能[美国足踝外科踝与后足功能(AOFAS)评分],随访期间并发症发生率.结果 两组手术时间、术中出血量、住院天数比较差异无统计学意义(P＞0.05);两组术后即刻与术后3个月以及两组组间TFCS、TFOL差异无统计学意义(P＞0.05);两组术后3个月踝关节活动度、AOFAS评分较术后1周均上升,且观察组高于对照组(P＜0.05);两组随访期间并发症发生率差异无统计学意义(P＞0.05).结论 带袢钛板与下胫腓螺钉在踝关节骨折并下胫腓联合不稳固定术中均能取得良好的临床效果,且具有一定安全性,而带袢钛板在促进患者术后踝关节功能恢复方面更具优势.
Abstract
Objective To compare and analyze the clinical effect of titanium plate with loop and lower tibiofibular screw during fixation for ankle fractures with lower tibiofibular syndesmosis instability.Methods The case data of 82 patients undergoing fixation for ankle fractures with lower tibiofibular syndesmosis instability in the hospital from January 2020 to December 2022 were retrospectively analyzed.Among the patients,38 cases with lower tibiofibular screw fixation were included in the control group,and 44 cases with titanium plate with loop for fixation were enrolled as the observation group.Both groups were followed up for 3 months after surgery.The surgical time,intraoperative blood loss and hospital stay,lower tibiafibular clear space(TFCS)and tibiofibular overlap distance(TFOL)immediately after surgery and 3 months after surgery,ankle range of motion(plantar flexion,dorsal extension)and ankle function American Orthopedic Foot and Ankle Society(AOFAS)score 1 week and 3 months after surgery and incidence rates of complications during follow-up were compared between two groups.Results There were no statistically significant differences in surgical time,intraoperative blood loss and hospital stay between the two groups(P＞0.05).There were no statistical differences in TFCS and TFOL in both groups immediately after surgery and at 3 months after surgery and between two groups(P＞0.05).The ankle range of motion and AOFAS score were increased 3 months after surgery in both groups compared with those 1 week after surgery,and the above indicators in observation group were higher than those in control group(P＜0.05).There were no statistical differences in the incidence rates of complications between two groups during follow-up(P＞0.05).Conclusion Both titanium plate with loop and lower tibiofibular screw can achieve good clinical effect and have certain safety during fixation for ankle fractures with lower tibiofibular syndesmosis instability,and titanium plate with loop is more advantageous in promoting postoperative ankle function recovery.
关键词
踝关节骨折/下胫腓联合不稳/切开固定术/带袢钛板/下胫腓螺钉Key words
Ankle fractures/Lower tibiofibular syndesmosis instability/Incision fixation/Titanium plate with loop/Lower tibiofibular screw引用本文复制引用
出版年
2024
NETL
NSTL
万方数据