探讨切开复位与韧带修复治疗三踝骨折伴胫腓联合分离的临床效果

Investigating the Clinical Effect of Open Reduction and Ligament Repair in the Treatment of Three-ankle Fracture with Sputum Separation

目的观察在三踝骨折伴胫腓联合分离治疗中采取切开复位与韧带修复治疗的临床疗效分析。方法方便选取在该院2016年1月—2017年12月收治以三踝骨折伴胫腓联合分离患者总计98例,随机数字法分成对照组(49例)与联合组(49例)。对照组仅采取切开复位治疗,联合组患者采取切开复位联合韧带修复治疗,并对两组患者进行9个月的随访至2018年9月。对照两组患者伤口愈合时间、住院时间、骨折愈合时间,术后随访不同时间平均踝关节评分(Baird-Jack),临床治疗优良率与并发症发生率对照。结果联合组患者伤口愈合、住院、骨折愈合时间明显少于对照组,差异有统计学意义(P<0.01)。联合组患者术后6个月Baird-Jack评分(92.95±0.56)分、9个月随访Baird-Jack评分(96.53±0.87)分,对照组术后6个月Baird-Jack评分(90.03±0.67)分、9个月随访Baird-Jack评分(93.56±0.98)分,差异有统计学意义(t=23.407 8,P=0.000 0;t=15.864 7,P=0.000 0)。联合组患者优良率为97.96%,并发症发生率为2.04%,对照组患者优良率为84.71%,并发症发生率为14.29%,差异有统计学意义(χ^2=4.900 0,P=0.026 7;χ^2=4.900 0,P=0.026 7)。结论在三踝骨折伴胫腓联合分离的治疗中,采取切开复位与韧带修复治疗,可明显缩短患者伤口愈合时间与骨折愈合时间,提高术后踝关节功能,提高临床治疗效果,减少术后并发症的发生,效果理想,值得临床推广。

Objective To observe the clinical efficacy of open reduction and ligament repair in the treatment of triple fracture combined with iliac crest. Methods A total of 98 patients with triple fractures and sputum combined with sputum in our hospital (January 2016-December 2017) were convenient randomly divided into control group (49 cases) and combination group (49 cases). The control group only underwent open reduction and treatment. The patients in the combined group were treated with open reduction and ligament repair. The patients in the two groups were followed up for 9 months until September 2018. The wound healing time, hospitalization time, fracture healing time, and the average ankle joint score (Baird-Jack) at different time after operation were compared between the two groups. The excellent rate of clinical treatment was compared with the incidence of complications. Results The wound healing, hospitalization and fracture healing time of the combined group were significantly lower than those of the control group, and the difference was statistically significant (P<0.01). The combined group had a Baird-Jack score of (92.95±0.56)points at the 6th month and a Baird-Jack score of 96.53±0.87 at the 9th month. The Baird-Jack score of the control group at 6 months after surgery (90.03±0.67)points. The Baird-Jack score (93.56±0.98)points was followed up for 9 months, and the difference was statistically significant (t=23.407 8, P=0.000 0;t=15.864 7, P=0.000 0). The excellent and good rate of the combined group was 97.96%, the complication rate was 2.04%, the excellent and good rate of the control group was 84.71%, and the complication rate was 14.29%. The difference was statistically significant (χ^2=4.900 0, P=0.026 7;χ^2=4.900 0, P=0.026 7). Conclusion In the treatment of tricuspid fracture combined with sputum separation, open reduction and ligament repair can significantly shorten the time of wound healing and fracture healing, improve the function of postoperative ankle joint, improve the clinical treatment effect, and reduce postoperative operation. The occurrence of complications is ideal and worthy of clinical promotion.