踝部旋前外展Ⅲ度骨折三种治疗方法的远期疗效比较

Comparison of three methods for long-term results in fracture of ankle with pronation and abduction degreeⅢ

目的:探讨手法整复夹板固定和切开复位内固定对踝部旋前外展Ⅲ度骨折的治疗效果及优缺点。方法:不同时期的171例踝部旋前外展Ⅲ度骨折分别应用手法整复夹板固定、切开复位松质骨螺丝钉加三棱髓内针内固定石膏外固定、切开复位张力带钢丝内固定三种方法进行治疗。结果:经2-16年,平均8.4年的随访,手法整复组优良率为39％;松质骨螺丝钉加三棱髓内针内固定石膏外固定组优良率为65％;张力带钢丝内固定组优良率为90％。三种方法疗效差异有显著性意义(P<0.05)。结论:张力带钢丝内固定对踝部旋前外展Ⅲ度骨折是一种较为理想的治疗方法。

Objective:To compare the results of manipulative reduction with splinting,and open reduction with internal fixation for fracture of ankle with pronation and abduction degree Ⅲ . Methods: One hunder and seventy-one patients of fracture of ankle with pronation and abduction degree Ⅲ were treated with three methods,manipulative reduction with splinting,open reduction with internal fixation of cancellous bone screw or triangular intramedullary pin, and open reduction with internal fixation of tension wire. Results: With the follow-up of 2-16 years (on average of 8.4 years) ,the good and excellent rate was 39% for manipulative reduction with splinting,65% for open reduction with screw fixation,and 90% for open reduction with tension wire, which showed significant difference among the three groups (P<0.05). Conclusion: Open reduction with tension wire internal fixation is the best method in treating fracture of ankle with pronation and abduction