前内侧入路与后外侧入路治疗踝关节后踝骨折的疗效评价

The curative effect of anterior medial approach and posterior lateral approach in the treatment of posterior malleolar fractures of ankle joint

目的探讨前内侧入路和后外侧入路治疗踝关节后踝骨折患者的疗效评价。方法我院90例行手术治疗后踝骨折患者,根据手术入路方式分为A组(42例)和B组(48例),A组利用前内侧入路治疗,B组选用后外侧入路治疗,比较两组疗效。结果A组手术时间、骨折愈合时间、完全负重时间均低于B组,术中出血量少于B组,术后AOFAS评分高于B组(P<0.05);两组术后6个月踝关节功能评价优良率比较,差异无统计学意义(P>0.05);A组术后并发症发生率低于B组,生活质量评分高于B组(P<0.05)。结论与后外侧入路相比,采用前内侧入路治疗踝关节后踝骨折可降低术中出血,加快骨折愈合和踝关节功能恢复,降低术后并发症率,提高患者生活质量。

Objective To explore the curative effect of anterior medial approach and posterior lateral approach in the treatment of posterior malleolar fractures of ankle joint.Methods A retrospective analysis was performed on case data of 90 patients with posterior malleolar fractures in our hospital.According to different surgical approaches,they were divided into group A(N=42)and group B(N=48).The group A was treated with anterior medial approach,while the group B was treated with posterior lateral approach.The effects were compared between the two groups.Results The operation time,fracture healing time and weight-bearing time were shorter,intraoperative blood loss was less and postoperative AOFAS score was higher in the group A than those in the group B(P<0.05).After 6 months of surgery,there was no significant difference in good rate of ankle joint function between the two groups(P>0.05).The incidence of postoperative complications was lower and quality of life scores were higher in the group A than those in the group B (P<0.05). Conclusion Compared with posterior lateral approach, anterior medial approach in the treatment of posterior malleolar fractures of ankle joint can reduce the intraoperative blood loss, promote the fracture healing and recovery of ankle function, reduce the incidence of postoperative complications, and improve their quality of life.