腓骨钩状钢板治疗腓骨远端不稳定骨折的临床研究

Clinical research of Lateral malleolar's anatomical hook-plate for unstable distal fibular fracture

目的通过比较临床应用腓骨钩状钢板、锁定钢板内固定治疗腓骨远端不稳定骨折,探讨腓骨钩状钢板治疗腓骨远端不稳定骨折的作用。方法选2008年1月至2011年1月伴有腓骨远端不稳定骨折的病例57例,按照完全随机设计方法,其中腓骨钩状钢板内固定治疗腓骨远端不稳定骨折29例,列为腓骨钩状钢板组;锁定钢板内固定治疗腓骨远端不稳定骨折28例,列为锁定钢板组。观察两组患者在不同内固定手术方式下的手术操作时间;术后踝关节功能评价应用Mazur评分体统进行研究。结果腓骨钩状钢板组患者评分结果优15例(51.7%)、良11例(37.9%),锁定钢板组患者优13例(46.4%)、良12例(42.9%);两组优、良率相比差异无统计学意义(P>0.05)。但是腓骨钩状钢板组手术操作时间比锁定钢板组短,差异有统计学意义(P<0.05)。结论腓骨钩状钢板内固定治疗腓骨远端不稳定骨折,使骨折断端易于达到解剖复位且骨折断端固定稳定,缩短了手术时间,术后可早期行踝关节功能锻炼,取得满意临床效果。

Objective To evaluate clinical effect of lateral malleolar~ anatomical hook - plate in treating ankle fracture including distal fibular fracture, which comparing lateral malleolarg anatomical hook - plate to locking plate fixation for distal fibula unstable fractures. Methods Fifty - seven patients of ankle fracture including distal fibular fracture were treated from January 2008 to January 2011. This research according to completely random design method, the lateral malleolar~ anatomical hook -plate（LMAH） group of 29 cases, and the locking plate fixation （LPF） group of 28 cases. Observation 2 groups of patients were operation time in different internal fixation of operation mode, The ankle function applica- tion Mazur rating system evaluation after the completion of the operation. Results The LMAH group of patients with operation treatment effect on the excellent rate was 51.7 %, and good rate is 37.9 % ;The LPF group of patients with operation treatment effect on the excellent rate was46.4%, and good rate is 42.9%. Comparing the two groups of excellent and good rate was not statistically significant （ P 〉0.05 ） , But the LMAH group of operation time shorter than the LPF group, and the difference was statistically significant （ P 〈 0. 05）. Conclusion Lateral malleolar anatom- ical hook - plate for unstable distal fibular fracture achieved satisfactory clinical effect, it makes the fracture in a short time is easy to reach anatom- ical reduction and fracture stability, and is helpful to early exercise ankle.