切开复位内固定术对踝关节骨折脱位患者的临床效果及安全性

Clinical Effect and Safety of Open Reduction and Internal Fixation for Patients with Fracture Dislocation of Ankle Joint

目的:研究切开复位内固定术对踝关节骨折脱位患者的临床效果及安全性。方法:选取2015年2月-2017年2月本院收治的踝关节骨折脱位患者98例,按照随机数字表法将其分为观察组(n=49)和对照组(n=49)。观察组给予手术切开复位内固定术治疗,对照组给予手法整复后石膏外固定治疗。比较两组手术时间、住院时间、骨折愈合时间、负重时间、疗效及并发症,治疗前后的疼痛程度(VAS评分)、踝关节功能(Baird-Jackson评分)、关节活动度,治疗后的生活质量(SF-36评分)。结果:观察组痊愈率、总有效率分别为77.55%、97.96%,均高于对照组的46.94%、85.71%,比较差异均有统计学意义(x^2=6.682、4.900,P=0.009、0.027);观察组骨折愈合时间、负重时间、手术时间、住院时间均显著少于对照组,比较差异均有统计学意义(P<0.05);治疗后,两组VAS评分均低于治疗前,Baird-Jackson评分均高于治疗前,且观察组改善程度均显著优于对照组,比较差异均有统计学意义(P<0.05);治疗后,观察组SF-36各项评分均高于对照组,比较差异均有统计学意义(P<0.05);术后3、6周,两组关节活动度均大于治疗前,且观察组均大于对照组,比较差异均有统计学意义(P<0.05);观察组并发症发生率4.08%,低于对照组的16.33%,比较差异有统计学意义(x^2=4.009,P=0.045)。结论:切开复位内固定术对治疗踝关节骨折脱位患者的临床效果显著,且安全可靠,值得临床借鉴。

Objective：To study the clinical effect and safety of open reduction and internal fixation for patients with fracture dislocation of ankle joint.Method：A total of 98 patients with fracture dislocation of ankle joint in our hospital from February 2015 to February 2017 were selected.According to the random number table method,they were divided into observation group（n=49） and control group（n=49）.The observation group was treated with open reduction and internal fixation,and control group was treated with plaster external fixation after manipulation.The operative time,hospitalization time,fracture healing time,weight bearing time,efficacy and complications,pain degree（VAS score）,ankle function（Baird-Jackson score） and joint range of motion before and after treatment,and quality of life（SF-36 score） after treatment between two groups were compared.Result：The cure rate and total effective rate in observation group were 77.55% and 97.96% respectively,which were higher than 46.94% and 85.71% in control group,the differences were statistically significant（ x^2=6.682,4.900;P=0.009,0.027）.The operative time,hospitalization time,fracture healing time,weight bearing time in observation group were significantly less than those of control group,the differences were statistically significant（P〈0.05）.After treatment,the VAS scores of two groups were all lower than those of before treatment,the BairdJackson scores were all higher than those of before treatment,and the improvement degree in observation group were significantly better than those of control group,the differences were statistically significant（P〈0.05）.After treatment,the each scores of SF-36 in observation group were higher than those of control group,the differences were statistically significant（P〈0.05）.After operation 3 and 6 weeks,the joint range of motion in two groups were greater than those of before treatment,and observation group were all larger than those of control group,the differences were statistically significant（P〈0.05）.The incidence of complications in observation group was 4.08%,which was lower than 16.33% of control group,the difference was statistically significant（ x^2=4.009,P=0.045）.Conclusion：The clinical effect of open reduction and internal fixation for patients with fracture dislocation of ankle joint is significant,safe and reliable,which is worthy of clinical reference.