经皮微创闭合复位与切开复位内固定治疗踝关节骨折的疗效比较

Comparison of the clinical efficacy of minimally invasive closed reduction and open reduction and internal fixation for ankle fracture

目的 比较经皮微创闭合复位与切开复位内固定治疗踝关节骨折的临床疗效.方法 选取踝关节骨折患者133例,采用随机数字表法分为闭合组65例与切开组68例.闭合组患者实施经皮微创闭合复位,切开组患者实施切开复位内固定.比较两组治疗疗效,术中出血量、骨折愈合时间、手术时间及术后并发症.结果 闭合组优良率（98.46％）高于对照组（85.29％）（χ2=7.594,P〈0.05）;闭合组术中出血量[（19.40±3.56）mL]少于切开组[（39.84±4.15）mL],骨折愈合时间[（10.24±2.15）周]短于切开组[（15.46±3.67）周],手术时间[（38.94±8.71）min]短于切开组[（59.38±13.25）min],差异均有统计学意义（t=30.424、9.950、10.462,均P〈0.05）;闭合组术后并发症发生率（1.54％）低于切开组（16.18％）（χ2=8.675,P〈0.05）.结论 经皮微创闭合复位治疗踝关节骨折的临床疗效优于切开复位内固定.

Objective To compare the clinical efficacy of minimally invasive closed reduction and open reduction and internal fixation in the treatment of ankle fractures. Methods 133 eases with ankle fractures were selected. They were divided into closed group （65 cases） and incision group （68 cases） according to random table method. The closed group was treated with minimally invasive closed reduction, and the incision group was treated with open reduction and internal fixation. The therapeutic effect, amount of bleeding, time of fracture healing, time of operation and postoperative complications were compared between the two groups. Results The good rate of the closed group （98,46%） was higher than that of the control group（85.29% ,χ2 =7, 594,P 〈0.05）. The amount of bleeding in the closed group [ （19, 40 ± 3.56） mL] was less than that in the incision group [ （39.84 ± 4.15 ）mL ], the fracture healing time in the closed group[ （10. 24 ±2. 15）weeks] was shorter than that in the incision group[ （15.46 ± 3,67 ）weeks ], the operation time in the closed group [ （38.94 ± 8.71 ）min ] was shorter than that the incision group [ （59.38± 13, 25 ） min] （ t = 30. 424,9.950,10. 462, all P 〈 0.05 ）. The incidence rate of postoperative complication in the closed group （ 1.54% ） was lower than that in the incision group （ 16. 18%, χ2 = 8. 675, P 〈 0. 05 ）. Conclusion Minimally invasive closed reduction in the treatment of ankle fractures is better than open reduction and internal fixation, and has important research value.