后内外侧联合切口内固定手术在陈旧性三踝骨折中的应用效果观察

Observation of effects of posterior lateral and medial incision internal fixation in treatment of old trimalleolar fractures

目的:观察后内外侧联合切口内固定手术在陈旧性三踝骨折中的应用效果。方法:选取70例陈旧性三踝骨折患者作为观察对象,依据随机数字法将其分为对照组和观察组各35例,对照组采用传统入路结合仰卧体位,观察组采取踝关节后内外侧联合切口内固定手术治疗,比较两组的手术情况(手术时间、术中出血量、术后影像学愈合时间及负重时间)、手术前后踝关节功能、术后疼痛程度及术后并发症发生情况。结果:观察组手术时间、影像学愈合时间及负重时间均明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P<0.05);踝关节功能评分优良率高于对照组,组间有统计学意义(P<0.05);观察组并发症发生率为8.6%(3/35),明显低于对照组的34.3%(12/35),差异有统计学意义(P<0.05)。结论:后内外侧联合切口内固定手术应用在陈旧性三踝骨折中,可明显缩短手术时间,减少术中出血量,促进术后骨折愈合及肢体功能恢复,且术后并发症较少。

Objective： To observe effects of combined posterior medial and lateral incision internal fixation in treatment of old trimalleolar fractures. Methods： 70 patients with old trimalleolar fractures were selected as observation subjects. According to the random number method, they were divided into control group and observation group, 35 cases in each. The control group was treated with traditional approach combined with supine body position, while the observation group was treated with posterior medial and lateral incision internal fixation. The situations（operation time, intraoperative blood loss, postoperative imaging healing time and weight-bearing time）, ankle joint function before and after the operation, postoperative pain and postoperative complications were compared between the two groups. Results： The operation time, imaging healing time and weight-bearing time of the observation group were all significantly shorter than those of the control group, the intraoperative blood loss was significantly less than that of the control group, and the differences were statistically significant（P〈0.05）. The goos and excellent rate of ankle function score was higher than that of the control group, and the difference was statistically significant（P〈0.05）. The incidence of complications in the observation group was 8.6%（3/35）, which was significantly lower than that of the control group（34.3%）, and the difference was statistically significant（P〈0.05）. Conclusions： The posterior medial and lateral joint incision internal fixation in the treatment of old trimalleolar fractures can shorten the operation time, reduce the intraoperative blood loss, and promote the healing of the fracture and the recovery of limb function with fewer complications.