空心螺钉结合钢板治疗三踝骨折的临床疗效观察

目的应用空心螺钉结合钢板治疗三躁骨折的临床疗效。方法选取沭阳县中医院骨科自2012年8月至2015年8月收治的三踝骨折患者42例，均采用空心螺钉结合钢板进行手术治疗，记录手术时间、出血量、术后住院时间，术后拍片复查观察骨折愈合情况并进行6～12个月随访。根据美国矫形外科足踝协会（AOFAS）Maryland足功能评分系统评价标准，对手术的效果进行评估。结果42例患者平均手术时间90min，术中平均出阻量150mL，平均住院时间10d。所有患者术后获6～12个月（平均10．3个月）随访，所有骨折均获愈合，愈合时间平均为3个月，无需二次手术取出内固定物。末次随访时按AOFAS的踝后足功能评分标准评定疗效：优30例，良7例，可5例，优良率为88．10％。术后患者各项评分较术前明最增高。P〈0．05．差异具有统计学意义。结论空心螺钉结合钢板治疗三踝骨折合并踝关节失稳的效果佳，愈合情况好，值得在临床上推广应用。

Objective Clinical effect of hollow screw combined with steel plate in the treatment of three ankle fractures. Methods Selected Shuyang County traditional Chinese medicine hospital from August 2012 and 2015 August were three ankle fractures in pa- tients with 42 eases were treated with hollow screws combined with plate fixation for surgical treatment, record the operation time, bleeding volume, postoperative hospital stay, postoperative film review fracture healing was observed and followed up for 6 to 12 months. According to the American Orthopaedic Foot and Ankle Society （AOFAS） Maryland foot function scoring system evaluation criteria, the surgical effect evaluation. Results 42 cases of patients, the mean operation time 90 min, the operation in the average bleeding volume was 150 ml, and the average length of time 10d. All the patients received 6-12 months （average 10.3 months follow- up, all fractures healed. The average healing time was 3 months, without a second operation to remove the internal fixators. At the time of the last follow-up according to AOFAS ankle foot function scores were used to evaluate efficacy： 30 cases were excellent, good in 7 cases, 5 cases, the excellent and good rate 88.10%. postoperative patients with the seore was significantly higher than that before oper- ation, P〈0.05, with statistical significance. Conclusion Hollow screw combined with steel plate in the treatment of three ankle frac- ture with ankle joint instability, good results, good healing, it is worth to be popularized in clinical application.