后外侧抗滑重建钢板与外侧解剖钢板在治疗Danis-Weber B 型三踝骨折的对比研究

Clinical comparative study of antiglide reconstruction plates by posterior-lateral approach and an-atomical plates by lateral approach in treatment of Danis-Weber type B trimalleolar fractures

目的：对比研究后外侧抗滑重建钢板与外侧解剖钢板治疗 Danis-Weber B 型三踝骨折的临床疗效。方法回顾性分析2011年6月至2013年8月符合纳入标准的46例 Danis-Weber B 型三踝骨折患者的临床资料，21例患者采用后外侧抗滑重建钢板治疗，25例患者采用外侧解剖钢板治疗，术后随访12～36个月，平均14.6个月。观察术后切口感染、骨折不愈合、腓骨肌腱炎等并发症，术后1年应用 Olerud and Monlander 系统对患者进行踝关节功能评分，采用成组设计的 t 检验，对两组受伤至手术时间、手术时间、住院时间以及踝关节功能评分进行评价。结果两组受伤至手术时间、手术时间、住院时间以及踝关节功能评分比较差异均未见统计学意义（ P 均＞0.05）。结论两种内固定对 Danis-Weber B 型三踝骨折的临床疗效相当。

Objective To investigate the clinical effects of antiglide plates and anatomical plates on Danis-Weber type B trimalleolar fractures. Methods All the 46 Danis-Weber type B trimalleolar fractures meeting the inclusion criteria were treated from June 2011 to August 2013. The 21 patients were treated by antiglide plate via posterolateral approach,the other 25 patients were treated by anatomical plate by posterior approach. The patients undertook a follow-up of 12-36 months,14. 6 months on aver-age. Complications such as infection,nonunion,peroneal tendonitis were observed. Ankle functions were assessed according to the Olerud and Monlander scoring system one year after surgery. All the data inclu-ding injury to operation time,operating room time,hospital stay and ankle joint functional scores,were analyzed with complete randomized design t-test. Results There was no difference in injury to operation time,operating room time,hospital stay or ankle joint functional scores between the two methods. Conclusions For Danis-Weber type B trimalleolar fractures,clinical results between antiglide plates and anatomical plates do not show statistical differences.