双Endobutton钢板与螺钉内固定治疗下胫腓联合损伤的疗效分析

Analysis of therapeutic effects of double Endobutton plate and screw internal fixation for distal tibiofibular syndesmosis injury

目的比较双Endobutton钢板与螺钉内固定治疗下胫腓联合损伤的临床疗效，为临床提供理论依据。方法下胫腓联合损伤患者47例，分为双Endobutton钢板组（A组，24例）和螺钉内固定组（B组，23例），比较两组患者术中出血量、手术时间和末次随访时下胫腓重叠距离（TBOL）、下胫腓间隙（TBCS）、AOFAS足踝评分优良率及疗效。结果所有患者均获得随访，随访时间6～18个月（平均12．4个月）。两组患者术中出血量、手术时间和末次随访时TBOL、TBCS比较差异均无统计学意义（P〉0．05）；末次随访时按AOFAS评分评定：A组优良率为95．8％，B组82．6％，两组比较差异有统计学意义（P〈0．05）。结论双Endobutton钢板固定更符合下胫腓联合的生物力学特征，无需常规取出，避免内固定物断裂，允许早期功能锻炼，恢复快，其疗效与螺钉固定相比具有优势。

Objective To compare the therapeutic effects of double Endobutton plate and inter- nal screw fixation for distal tibiofibular syndesmosis injury and provide a scientific basis for clinical appli- cation. Methods The clinical data of 47 patients,such as mean blood loss,operation time,TBOL,TBCS, AOFAS ankle hind foot score at the last follow-up and therapeutic effects with distM tibiofibular syndesmo- sis injury,were retrospectively reviewed and compared, including 24 eases with double Endobutton plate （group A） and 23 eases with screw internal fixation （group B）. Results All patients were followed up for 6-18 months, with an average of 12.4 months. There was no statistical difference between the two groups in mean blood loss,operation time,TBOL and TBCS （P 〉 0.05）. According to the AOFAS score, 95.8% patients in group A and 82.6% patients in group B were assessed as good. There was a significant difference between the two groups （P 〈 0.05 ）. Conclusion The double Endobutton fixation conforms to the biomechanics of distal tibiofibular syndesmosis, and it does not need to be removed, which avoid the breakage of internal fixation, allow patients to do early exercise and has the advantage of quick recovery. It has advantages in the treatment of distal tibiofibular syndesmosis injury.