闭合复位经皮空心螺钉内固定术在踝关节骨折中的应用

Application of closed reduction and percutaneous hollow screw fixation in ankle fracture

目的探讨闭合复位经皮空心螺钉内固定术在踝关节骨折中的应用价值。方法选择2018年3月~2019年3月我院收治的80例踝关节骨折患者为研究对象,按照随机数字表法分为两组,每组各40例。对照组行常规切开复位内固定术,观察组实施闭合复位经皮空心螺钉内固定术,门诊随访1年,比较两组骨折愈合临床指标、美国踝关节协会(AOFAS)评分及并发症发生情况。结果观察组骨折X线愈合时间短于对照组,差异有统计学意义(P<0.05);观察组弃拐行走时间及主动承重活动时间均短于对照组,差异有统计学意义(P<0.05);术后3个月和术后1年,观察组AOFAS评分均高于对照组,差异有统计学意义(P<0.05);观察组发生切口感染、慢性关节疼痛、关节僵硬及内固定松动的总比例低于对照组,差异有统计学意义(P<0.05)。结论针对踝关节骨折,实施闭合复位经皮空心螺钉内固定术,能有效地促进患者术后骨折愈合,促进术后早期下床及承重活动,提高踝关节功能,且并发症少,安全性高。

Objective To explore the application value of closed reduction and percutaneous hollow screw internal fixation in ankle fracture.Methods A total of 80 cases with ankle fracture admitted to our hospital from March 2018 to March 2019 were divided into two groups by the random number table method,with 40 cases in each group.The control group received routine open reduction and internal fixation,while the observation group received closed reduction and percutaneous hollow screw internal fixation.The outpatient follow-up period was 1 year,and the clinical indexes of fracture healing,the changes of American Ankle Association(AOFAS)scores,the complications were compared between the two groups.Results The X-ray healing time of fracture in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05);and the walking time and active load-bearing activity time of abandoned crutches in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05);the AOFAS score in the observation group was higher than that in the control group 3 months and 1 year after operation,the differences were statistically significant(P<0.05);the total proportion of incision infection,chronic joint pain,joint stiffness and internal fixation loosening in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion For ankle fractures,closed reduction and percutaneous hollow screw internal fixation can effectively promote postoperative fracture healing of patients,promote early postoperative ambulation and load-bearing activities,improve ankle function,and have fewer complications and high safety.