1/3管型接骨板在踝关节后踝骨折手术中的应用

Application effect of 1/3 tubular plate on operative treatment of posterior malleolar fractures of the ankle

目的:比较1/3管型接骨板和空心拉力螺钉在踝关节后踝骨折手术中的临床疗效。方法:选择我院2014年1月至2016年1月踝关节后踝骨折患者56例。其中后踝采用1/3管型接骨板固定者35例为观察组,后踝采用空心拉力螺钉固定者21例为对照组。对比分析其影像学疗效、踝关节功能评分及并发症发生率。结果:所有患者均得到随访,随访时间11~18个月,平均14.5个月。所有患者中,3例术后切口感染(观察组2例,对照组1例);1例空心螺钉松动(对照组);6例长时间行走感踝部酸痛不适(观察组1例,对照组5例)。所有患者骨折3~6个月均骨性愈合,平均愈合时间4.5个月。1/3管型接骨板内固定患者的影像学评价及Mazur踝关节评分均优于空心拉力螺钉内固定者患者,而晚期并发症发生率少于空心钉组,差异均有统计学意义(P<0.05)。结论:1/3管型接骨板内固定治疗踝关节后踝骨折较空心拉力螺钉固定更有优势,能提高其影像学疗效与踝关节功能,且安全性较高。

Objective： To analyze and c ompare the clinical efficacy of 1/3 tubular plate and cannulated lag screws in the treatment of posterior malleolar fractures of the ankle. Methods： From January 2014 to January 2016,56 patients with posterior malleolar fractures of the ankle were selected and divided into two groups： 1/3 tubular plate group with 35 cases （observation group ） and cannulated lag screws group with 21 cases （control group）,and the radiographic effects,ankle function scores, complication rates of the patients were compared and analyzed. Results ： All the patients were followed up 11 to 18 months with an average of 14. 5 months. Incision infection occurred in three patients （two cases of observation group, one case of control group）. Cannulated lag screw loosening occurred in one case of control group. Walking for a long time with the sense of ankle pain occurred in six patientsCone case of observation group, five cases of control group）. All the fractures were healed within 3-6 months （averaged 4. 5 months）. In the radiographic effects,ankle function scores,late complication rates of observation group were better than the control group. The difference of two groups was statistically significant （P 〈 0. 05）. Conclusions ： 1/3 tubular plate applied in patients with posterior malleolar fractures had clinical advantage over cannulated lag screws,and it can improve the radiographic efficacy and ankle joint function, and with high level of safety.