关节镜辅助下弹性固定急性下胫腓联合损伤的临床研究

Effects of endobutton elastic fixation associated with arthroscopic exploration on acute distal tibiofibular syndesmosis injury

目的:探讨关节镜辅助下Endobutton弹性固定急性下胫腓联合损伤的临床效果。方法:在2011年1月至2012年5月期间,对38例下胫腓联合损伤的患者采用关节镜辅助下双Endobutton弹性固定或者金属螺钉固定的方法治疗。比较术后早期、术后3个月、术后6个月、末次随防时的TBCS、TBOL及AOFAS足踝功能评分优良率。结果:Endobutton组和金属螺钉组患者分别为18、20例,2组间术后初期、术后3个月、术后6个月及末次随防时TBCS、TBOL比较差异无统计学意义(P>0.05),2组间AOFAS评分术后3个月比较差异有统计意义(P<0.05),Endobutton组优于金属螺钉组,而术后6个月及末次随防时比较差异无统计意义(P>0.05)。结论:与传统方法相比,关节镜辅助下弹性内固定不仅利于诊断下胫腓联合损伤,而且提供更加精确的弹性内固定,利于术后早期活动。

[ Objective] To investigate the effect of endobutton elastic fixation associated with arthroscopic exploration on treating acute distal tibiofibular syndesmosis injury. [ Method] From 2011 january to 2012 may, 38 patients with acute distal tibiofibular syndesmosis injury were treated with endobutton elastic fixation associated with arthroscopic exploration or traditional screws. 1 8 patients and 20 patients were respectively included in the endobutton group and the screw group. The TBCS, TBOL and AOFA ankle hind foot score were compared at early stage, 3, 6 months after operation and the last follow- up. [Result] Between the two groups, there were no significant differences about TBCS, TBOL in every recording point（ P 〉 0.05）. At posteropemtive 3 months, the Endobutton group showed higher AOFAS score（ P 〈 0.05）, but no significant differences in the other two time point（ P 〉 0.05）. [ Conclusion] Compared to traditional treatment, the new procedure could diagnose the acute distal tibiofibular syndesmosis injury much more easily and has preciser elastic reduction and benefits in early motion.