锚钉修补联合切开复位内固定术治疗踝关节三踝骨折伴内侧副韧带损伤疗效分析

Analysis of the curative effect of anchor repair combined with open reduction and internal fixation in the treatment of ankle trimalleolar fracture with medial collateral ligament injury

目的探讨锚钉修补联合切开复位内固定术治疗踝关节三踝骨折伴内侧副韧带损伤的临床疗效,为临床后续治疗提供参考依据。方法将2016年4月—2019年6月宁波大学医学院附属医院骨科收治的77例踝关节三踝骨折伴内侧副韧带损伤患者作为研究对象,对所选患者进行锚钉修补联合切开复位内固定术治疗。所有患者均随访1.5年,运用Baird标准对踝关节功能进行评估,同时观察机械性踝关节不稳等相关并发症发生情况。结果77例踝关节三踝骨折伴内侧副韧带损伤患者行锚钉修补联合切开复位内固定术后全部复位成功,术后功能恢复较为满意;交通事故伤、运动伤、坠落伤患者切开复位内固定术后踝关节功能恢复优良率分别为100.00%、100.00%、90.48%,3种不同损伤因素的踝关节三踝骨折伴内侧副韧带损伤患者踝关节功能恢复优良率比较差异无统计学意义(χ^2=5.476,P=0.144);术后1.5年随访中均未出现机械性踝关节不稳等相关并发症。结论踝关节三踝骨折伴内侧副韧带损伤患者行锚钉修补联合切开复位内固定术,可有效提升踝关节灵活性、稳定性,且踝关节恢复情况佳。

Objective To investigate the clinical efficacy of anchor repair combined with open reduction and internal fix-ation in treatment of ankle trimalleolar fracture with medial collateral ligament injury,and provide reference for clinical follow-up treatment.Methods Total 77 patients with ankle trimalleolar fracture and medial collateral ligament injury treated with anchor repair combined with open reduction and internal fixation in Department of Orthopaedics,Affiliated Hospital of Medical College of Ningbo University from April 2016 to December 2017 were selected.All patients were fol-lowed up for 1.5 years.The ankle function was evaluated by Baird standard.At the same time,the incidence of mechan-ical ankle instability and other related complications were observed.Results Total 77 cases of ankle trimalleolar fracture with medial collateral ligament injury were successfully treated with open reduction and internal fixation,and the function-al recovery was satisfactory.The excellent and good rate of ankle joint function recovery after open reduction and internal fixation for traffic accident injury,sports injury and fall injury was 100.00%,100.00%and 90.48%,respectively.There was no significant difference in the excellent and good rate of ankle joint function recovery among the three different injury factors(χ^2=5.476,P=0.144).No complications such as mechanical ankle instability occurred during the 1.5-year follow-up.Conclusion Anchor repair combined with open reduction and internal fixation for ankle trimalleo-lar fracture with medial collateral ligament injury can effectively improve the flexibility and stability of ankle joint,and the recovery of ankle joint is good.