锁定钢板治疗不同Lauge-Hanse分型后踝骨折的效果

The Effect of Locking Plate in the Treatment of Ankle Fracture of Different Lauge-Hanse Types

目的探讨锁定钢板内固定对不同Lauge-Hanse分型老年骨质疏松性后踝骨折患者的治疗效果。方法笔者对本院骨科2011年1月至2014年1月收治的98例老年骨质疏松性后踝骨折患者进行回顾性分析,依据LaugeHanse分型分为旋后外旋型50例、旋前外旋型48例,两组患者均采取锁定钢板内固定治疗,观察锁定钢板内固定治疗不同分型后踝骨折的效果。结果旋后外旋型与旋前外旋型两组患者的手术时间、术中出血量、术后下地时间、骨折愈合时间比较差异均无统计学意义(P>0.05);术后4、8、12周旋后外旋型与旋前外旋型两组患者的骨痂形成评分组间比较差异均无统计学意义(P>0.05);术后第12周两组患者的骨痂形成评分较本组术后4周、12周均显著的提高(P<0.05);术后末次随访旋后外旋型组患者的踝关节功能恢复优良率92.00%与旋前外旋型组患者的87.50%差异无统计学意义(P>0.05)。结论锁定钢板内固定对旋后外旋型与旋前外旋型老年骨质疏松性后踝骨折患者均具有较好的临床效果,术后患者踝关节功能恢复良好。

Objective To investigate the effect of locking plate fixation for the treatment of osteoporotic fracture of the elderly with different Lauge-Hanse types. Methods From January 2011 to January 2014,98 patients with osteoporosis ankle fractures were admitted by our department. According to the different types of Lauge-Hanse,50 cases were of supination external rotation type,48 cases were of pronation external rotation type. Two group patients underwent open reduction and locking plate internal fixation for the treatment of different types of posterior malleolar fractures. Results There were no significant difference in the operation time,intraoperative bleeding volume,operation time,fracture healing time（ P〉0. 05） between the two group. After 4,8,12 days after operation,there were no significant difference in callus formation scores（ P〉0. 05）. 12 weeks after operation,both groups had more bone callus formation score compared with the group after 4 weeks（ P〈0. 05）. At the end of the follow-up,supination external rotation type group of patients had an excellent and good rate of 92% in ankle joint function recovery,while pronation external rotation type groups had an excellent and good rate of 87. 50%. There were no significant difference between them（ P〉0. 05）. Conclusion The locking plate internal fixation has good clinical effect on the treatment of the elderly patients with osteoporosis ankle fractures of supination external rotation type or pronation external rotation type. After operation,the function of ankle joint of patients recover well.