T型锁定钢板与空心螺钉治疗后踝骨折的效果研究

Study on the Effect of T-shaped Locking Plate and Hollow Screw in the Treatment of Posterior Malleolus Fracture

目的:比较T型锁定钢板与空心螺钉治疗后踝骨折的疗效。方法:回顾性分析2014年3月-2016年8月手术治疗的39例后踝骨折手术患者。采用空心螺钉固定23例,采用T型锁定钢板固定16例。术后以美国足-踝外科协会(AOFAS)的足踝评分系统评估疗效。结果:钢板组骨折临床愈合时间长于螺钉组,差异有统计学意义(P<0.05);钢板组完全负重时间早于螺钉组,差异有统计学意义(P<0.05)。术后半年及术后1年AOFAS评分,螺钉组低于钢板组,但差异无统计学意义(P>0.05)。螺钉组和钢板组优良率分别是78.3%和81.3%。结论:T型锁定钢板和空心螺钉都是治疗后踝骨折的理想方法,对于粉碎的后踝骨折建议采用T型锁定钢板固定,支撑效果更可靠。

Objective:To compare the clinical results of T-shaped locking plate and hollow screw in the treatment of posterior malleolus fractures.Methods:From March 2014 to August 2016,39 cases with posterior malleolus fractures were treated.23 cases were treated with hollow screws,16 cases were treated with T-shaped locking plates.The score was evaluated by the ankle scoring system of the American Foot-Ankle Surgery Association(AOFAS).Results:In the clinical healing time of fracture,the plate group was longer than the screw group,the difference was statistically significant(P<0.05).In the time of complete load-bearing,the plate group was significantly shorter than the screw group,the difference was statistically significant(P<0.05).After six months and one year,the averaged AOFAS scores of the screw group were lower than the plate group,but the difference was not statistically significant(P>0.05).The excellent and good rates of the screw group and plate group were 78.3% and 81.3% respectively.Conclusion:Fixation with T-shaped locking plate or hollow screw are all ideal treatment for posterior malleolus fractures.For the comminuted posterior malleolus fracture,it is recommended to use T-shaped locking plate to get the supporting effect more reliably.