带孔金属骨针钛缆张力带与克氏针钢丝张力带治疗内踝骨折疗效比较

Efficacy comparison of cannulated metal bone needle titanium cable tension band and Kirschner wire tension band for treatment of medial malleolus fractures

目的比较带孔金属骨针钛缆张力带与克氏针钢丝张力带治疗内踝骨折的临床效果。方法 63例内外踝骨折患者外踝骨折统一行钛板及螺钉内固定;内踝骨折按治疗方法分成两组:A组(32例)行带孔金属骨针钛缆张力带固定,B组(31例)行克氏针钢丝张力带固定。观察两组切口长度、手术时间、术中出血量、骨折愈合时间及术后内踝术区舒适度,按照AOFAS踝-后足关节功能评分评价疗效。结果 63例均获得12个月随访。手术切口长度、术中出血量、手术时间、骨折愈合时间两组比较差异均无统计学意义(P>0.05)。术后12个月AOFAS踝关节功能评分:A组优28例,良2例,中2例,优良率93.8%;B组优25例,良4例,中2例,优良率93.5%;两组优良率比较差异无统计学意义(P>0.05)。术区舒适度:A组无疼痛病例,异物感2例,无不适30例,舒适度为93.8%;B组疼痛4例,异物感5例,无不适22例,舒适度为71.0%;A组术区舒适度明显优于B组(P<0.05)。结论与克氏针钢丝张力带比较,带孔金属骨针钛缆张力带治疗内踝骨折术区软组织激惹小,患者术区舒适度更好。

Objective To compare the clinical effect of cannulated metal bone needle titanium cable tension band and Kirschner wire tension band in the treatment of medial malleolus fractures. Methods The 63 patients with medial and lateral malleolus fractures underwent surgery. All patients with lateral malleolus fractures were treated with titanium plate and screw fixation. Medial malleolus fractures were divided into two groups according to the treatment method： group A with cannulated metal bone needle titanium cable tension band fixation（ 32 cases）,group B with the Kirschner wire tension band fixation（ 31 cases）. The incision length,operation time,intraoperative blood loss,fracture healing time and postoperative ankle surgery comfort were observed. The curative effect was evaluated according to AOFAS ankle-hind foot function score. Results All 63 cases were followed up for 12 months. There were no significant differences in the incision length,intraoperative blood loss,the operation time,and fracture healing time（ P〉0.05）. AOFAS ankle function score of 12 months postoperation： group A of excellent 28 cases,good 2 cases,fair 2 cases,excellent-good rate was 93. 8%; group B of excellent 25 cases,good 4 cases,fair 2 cases,excellent-good rate was 93. 5%,there was no significant difference between the two groups（ P〉0.05）. Operation area comfort degree：group A of pain in 0 case,foreign body sensation in 2 cases,without uncomfort in 30 cases,comfort degree was93. 8%; group B of pain in 4 cases,foreign body sensation in 5 cases,without uncomfort in 22 cases,comfort degree of 71. 0%,group A was significantly better than group B（ P〈0.05）. Conclusions Compared with Kirschner wire tension band,cannulated metal bone needle titanium cable tension band for treatment of patients with medial malleolus fracture has better operation area comfort,less soft tissue irritation.