保守疗法与手术疗法治疗旋后外旋型踝关节骨折临床疗效比较研究

The Conservative Therapy and Operation Therapy for the Treatment of Supination External Rotation Ankle Fractures Clinical Comparative Study

目的：对比分析保守疗法以及手术疗法在治疗旋后外旋型踝关节骨折患者的临床疗效，并对其适应症及影响因素进行分析。方法选取2012年6月～2013年12月在我院骨科住院治疗的旋后外旋型踝关节骨折患者例46例作为研究对象，根据患者治疗方案的不同将患者分为保守组和手术组，其中保守组患者20例，手术组患者26例，保守组患者采用手法复位联合石膏外固定进行治疗，手术组患者采用切开复位内固定术进行治疗，对比两组患者治疗后踝关节功能活动以及X片评分，并对其住院时间及治疗费用等进行记录。结果对于患者的旋后外旋型踝关节骨折的不同程度，采用不同的治疗方法，I度和II度损伤适合于保守治疗，III与IV度损伤患者则更适合手术治疗。结论对于II度损伤的旋后外旋型踝关节骨折的患者来说，保守治疗与手术治疗的临床效果无显著差异；对于III与IV度损伤患者来说，手术组，在骨折复位以及关节恢复上显著优于保守组，建议此类患者采用手术治疗。

Objective Comparative analysis of the conservative therapy and operation therapy in the treatment of supination external rotation ankle fractures in patients with clinical efficacy, and the factors to disease and effect analysis.Methods Select 46 cases of cases as the object of study in 2012 June to 2013 December in Department of orthopedics of our hospital in-patient treatment according to the different patients the conservative group and operation group, including 20 cases of patients with conservative group, operation group of 26 patients, conservative group were treated by manipulative reduction combined with external fixation of plaster, operation group were treated by open reduction and internal fixation for treatment, compared two groups of patients after the treatment of ankle joint function activities and X film score, and records the time of hospitalization and treatment costs.Results For the patients with different degrees of supination external rotation ankle fractures, treated by different methods, I and II degrees damage suitable for conservative treatment, III and IV ofpatients with injury is more suitable for operation treatment.Conclusion For the II degree injury of supination external rotation ankle fractures patients, no significant difference in clinical effect of conservative treatment and operation treatment; for III and IV injury patients in the recovery group, operation, significantly better than conservative groupreduction and joint fracture, suggest that such patients treated with operation.