带孔克氏针加压张力带治疗胫腓骨内外踝骨折效果观察

Effect of Kirschner Wire and Tension Band for the Treatment of Internal and External Malleolus Fractures of Tibia and Fibula

目的:探讨带孔克氏针加压张力带治疗胫腓骨内外踝骨折临床效果及并发症发生率。方法:选取2014年2月-2016年8月厦门市第三医院骨科收治的胫腓骨内外踝骨折患者80例作研究对象,应用投掷硬币法将患者随机分为对照组及观察组,每组40例。对照组采用传统开放手术钢板固定治疗,观察组采用带孔克氏针加压张力带治疗。观察两组患者临床疗效、术后12个月踝关节功能评分及并发症发生率。结果:观察组治疗12个月后关节功能评定优良率为95.0%,显著高于对照组的70.0%,差异有统计学意义(X^2=2.940,P=0.003);观察组治疗期间发生晚期创伤性关节炎病例1例,对照组并发骨折延迟愈合1例,两组并发症发生率比较差异无统计学意义(P>0.05);两组患者治疗后Baird-Jackson评分分别为(94.3±2.3)分和(91.2±2.2)分,观察组高于对照组,差异有统计学意义(t=4.070,P=0.000)。结论:与传统开放手术钢板固定术相比,带孔克氏针加压张力带治疗胫腓骨内外踝骨折临床疗效确切,术后踝关节功能恢复良好,不良反应发生率低。

Objective： To investigate the clinical efficacy and complications of internal fixation with Kirschner wire and tension band for the treatment of internal and external malleolus fractures of tibia and fibula.Method： 80 cases of patients with internal and external malleolus fractures of tibia and fibula treated in Third Hospital of Xiamen from February 2014 to August 2016 were selected as the research object, the application of coin toss method were randomly divided into control group（n=40）, trewted with the traditional open surgery and plate fixation for the treatment and observation group（n=40）, trewted with Kirschner wire with tension with treatment.The clinical efficacy of two groups of patients, postoperative ankle function score and the incidence of complications were compared between the 6 groups.Result： The observation group after 12 months of treatment joint function evaluation excellent rate was 95%, significantly higher than 70% in the control group（x2=2.940, P=0.003）; 1 case of late traumatic arthritis occurred during the treatment in the observation group, the control group with 1 cases of fracture delayed healing, there was no significant difference of complications in the two groups （P〉0.05）.After the treatment, the Baird-Jackson score of patients in two groups were （94.3 ± 2.3）scores and （91.2 ± 2.2）scores, the observation group was higher than the control group, the difference was statistically significant （t=4.070, P=0.000）.Conclusion ： Compared with the traditional open plate fixation, the treatment of internal and external malleolus fractures of the tibia and fibula with the Kirschner wire tension band is effective.