踝关节骨折并下胫腓骨分离手术治疗分析

Analysis of Surgical Treatment of Ankle Fracture with Lower Tibiofibula Separation

目的:分析踝关节骨折并下胫腓骨分离最优手术方案.方法:选择2016年7月-2018年7月我院收治的106例踝关节骨折并下胫腓骨分离患者为研究对象.依照就诊次序,将其随机分为对照、观察2组.在此其中观察组62例,对照组44例.患者均使用拉力螺钉治疗.观察组受试者拉力螺钉应贯穿2层腓骨皮质以及外侧胫骨皮质.对照组拉力螺钉应贯穿两侧腓骨皮质和2层胫骨皮质.分析结果.结果:相较于对照组,观察组受试者治疗优良率明显更高,P<0.05.I期伤口愈合共计102例.4例患者发生伤口红肿现象.经换药之后全面愈合.不存在显著感染、骨髓炎案例.观察组受试者发生拉力螺钉松动共计4例,占据6.45%.对照组受试者拉力螺钉松动2例,占4.55%.相较于对照组,观察组受试者拉力螺钉断裂率明显更低,P<0.05.结论:对于踝关节骨折并下胫腓骨分离者,使用拉力螺钉穿透3层皮质治疗,能取得满意成效.此法值得进一步推广.

Objective:To analyze the optimal surgical procedure for ankle fracture with lower tibiofibula separation.Methods:106 cases of ankle fractures with lower tibiofibular separation admitted to our hospital from July 2016 to July 2018 were selected as the research objects.They were randomly divided into control group and observation group according to the order of visit.A m o n g t h e m,there were 62 cases in the observation group and 44 cases in the control group.All patients were treated with lag screw.Subjects in the observation group received lag screws through 2 layers of the peroneal cortex and lateral tibial cortex.In the control group,lag screws were inserted through both flbular cortex and two layers of tibial cortex.Analyze the results.Results:Compared with the control group,the excellent and good rate of treatment in the observation group was significantly higher,p<0.05.Stage I w o u n d healing was 102 cases in total.W o u n d redness and swelling occurred in 4 patients.After dressing c hange,it completely healed.There were no significant cases of infection or osteomyelitis.In the observation group,there were 4 cases of lag screw loosening,accounting for 6.45%.Lag screw loosening was found in 2 cases(4.55%)of subjects in the control group.Comp a r e d with the control group,the fracture rate of lag screw in the observation group was significantly lower,p<0.05.Conclusion:For patients with ankle fractures with lower tibiofibular separation,lag screws can be used to penetrate the three layers of cortex and obtain satisfactory results.This method deserves to be further extended.