外固定器治疗踝关节骨折脱位整复后踝关节不稳的临床研究

Clinical Research on Treatment of Ankle Instability with External Fixation Device after Bone-setting Manipulation of Ankle Fracture Dislocation

目的:总结外固定器治疗踝关节骨折脱位整复后踝关节不稳的经验,观察其临床疗效,初步探讨其作用机理。方法:我们共搜集100例病例,50例为治疗组,50例为对照组。全部病例均来自湖北中医药大学附属襄阳医院正骨科及下肢骨科病房。治疗组通过外固定器进行治疗;对照组通过西医常规手术进行治疗。所有病例根据Baird踝关节评分标准分别在治疗后第2天、2周、4周、8周、24周进行评分并比较以及在治疗12周时对踝关节稳定性进行评价并比较。所有病例在治疗后8周进行疗效评定。结果:治疗组和对照组在治愈率及有效率上比较差异无统计学意义(P>0.05)。治疗后第2天、第2周、第4周、第8周及第24周,治疗组和对照组在症状缓解上比较差异有统计学意义(P<0.01)。结论:踝关节骨折脱位整复后踝关节不稳通过外固定器进行治疗后,不论是短期还是远期,患者的症状均得到明显改善。

To summarize the experience in treating ankle instability with external fixation device after ankle fracture dislo- cation and reduction, observe its clinical curative effect, and to explore its mechanisms involved. Methods：One hundred cases of an- kle instability were selected and randomly divided into two groups. Patients in the treatment group were treated by external fixation device, while patients in the control group underwent routine operation treatment. At the end of 2 days, 2 weeks, 4 weeks, 8 weeks and 24 weeks of treatment, Baird Scoring System for ankle fracture was used to assess all cases. At the end of 12 weeks, the stability of ankle in all cases was evaluated. The clinical effective rate was evaluated after 8 weeks treatment. Results：There was no significant difference in cure rate of and total effective rate between treatment group and control group. There was significant differ- ence in improving the patients symptoms between the two groups after treating 2 days, 2 weeks, 4 weeks, 8 weeks and 24 weeks. Conclusion：External fixation device is effective for ankle instability. Patients symptoms can be improved obviously by the external fixation device either in the short term or long term.