切开复位内固定联合手术修复韧带治疗踝关节骨折伴有三角韧带损伤的临床效果

Clinical effect of open reduction and internal fixation combined with surgical repair of ligament for ankle fracture with deltoid ligament injury

目的探讨切开复位内固定结合手术修复韧带治疗踝关节骨折伴有三角韧带损伤的临床效果及优势。方法将我院收治的86例踝关节骨折伴三角韧带损伤患者随机分为对照组和观察组,各43例。对照组行切开复位内固定手术,观察组行切开复位内固定联合手术修复韧带。比较两组的治疗效果。结果观察组手术时间、住院时间和骨折愈合时间显著优于对照组(P<0.05)。术后3个月,两组患者VAS评分均显著降低,且观察组显著低于对照组(P<0.05)。术后3、6个月,两组患者的AOFAS评分均高于术前,且观察组高于对照组(P<0.05)。术后6个月,两组患者距骨前移距离、距骨倾斜角及患侧内踝间隙均显著减小,且观察组均小于对照组(P<0.05)。结论切开复位内固定联合手术修复韧带能够加快踝关节骨折伴三角韧带损伤患者骨折愈合,缓解疼痛,改善踝关节功能。

Objective To investigate the clinical effect and advantages of open reduction and internal fixation combined with surgical repair of ligament for ankle fracture with deltoid ligament injury.Methods A total of 86 patients with ankle fracture and deltoid ligament injury admitted in our hospital were randomly divided into control group and observation group,with 43 cases in each group.The control group was treated with open reduction and internal fixation,and the observation group was treated with open reduction and internal fixation combined with surgical repair of ligament.The therapeutic effects of two groups were compared.Results The operation time,hospital stay and fracture healing time of the observation group were significantly better than those of the control group(P<0.05).Three months after operation,the VAS scores of the two groups decreased significantly,and that in the observation group was significantly lower than the control group(P<0.05).At 3 and 6 months after operation,the AOFAS scores of the two groups were higher than those before operation,and that in the observation group was higher than the control group(P<0.05).At 6 months after operation,the anterior distance of talus,the tilt angle of talus and the medial malleolus space of affected side reduced significantly in both groups,and those in the observation group were smaller than the control group(P<0.05).Conclusion Open reduction and internal fixation combined with surgical repair of ligament can accelerate fracture healing,relieve pain and improve ankle function in patients with ankle fracture and deltoid ligament injury.