改良踝关节后外侧、前内侧联合入路治疗三踝骨折的临床疗效分析

Analysis of clinical efficacy of modified posterolateral and anteromedial approach on the treatment of Cotton’s fracture

目的分析三踝骨折患者治疗中,改良踝关节后外侧、前内侧联合入路治疗的效果。方法 40例三踝骨折患者,随机分为研究组和常规组,各20例。研究组接受改良踝关节后外侧、前内侧联合入路治疗,常规组接受外侧+内侧联合入路治疗。对比两组各项手术指标、踝关节功能、舒适状况量表(GCQ)评分、治疗满意度评分。结果研究组手术时间(90.23±17.23)h、骨折愈合时间(12.25±1.42)周均短于对照组的(107.24±21.26)h、(13.46±1.59)周,术中出血量(46.25±10.82)ml少于对照组的(60.12±13.22)ml,切口愈合率100.00%高于对照组的80.00%,差异均有统计学意义(P<0.05)。研究组优良率为95.00%,高于常规组的55.00%,差异有统计学意义(P<0.05)。研究组生理、心理、社会文化、环境评分分别为(2.51±0.52)、(3.12±0.55)、(3.07±0.28)、(3.14±0.61)分,均高于对照组的(2.07±0.75)、(2.13±0.14)、(2.32±0.37)、(2.41±0.56)分,差异均有统计学意义(P<0.05)。研究组患者治疗满意度评分为(91.1±2.4)分,高于常规组的(82.7±3.7)分,差异有统计学意义(P<0.05)。结论三踝骨折患者实施治疗时,相对于传统踝关节后外侧、内侧联合入路治疗措施,改良踝关节后外侧、前内侧联合入路治疗措施所获得的治疗效果更为理想,可在临床中推广运用。

Objective To analyze the effect of modified posterolateral and anteromedial approach on the treatment of Cotton’s fracture. Methods A total of 40 Cotton’s fracture patients were randomly divided into research group and conventional group, with 20 cases in each group. The research group was treated by modified posterolateral and anteromedial combined approach, while the conventional group was treated by the lateral and medial combined approach. The surgical indicators, ankle function, general comfort questionnaire(GCQ) score and satisfaction score were compared between the two groups. Results The surgery time(90.23±17.23) h, fracture healing time(12.25±1.42) weeks of the research group was shorter than those of the conventional group(107.24±21.26) h,(13.46±1.59) weeks, amount of intraoperative hemorrhage(46.25±10.82) ml was less than that of the conventional group(60.12±13.22) ml, and incision healing rate 100.00% was higher than that of the conventional group 80.00%, and the difference was statistically significant(P<0.05). The excellent rate of the research group was 95.00%, which was higher than that of conventional group 55.00%, and the difference was statistically significant(P<0.05). The score of physiology, psychology, social culture and environment of the research group was(2.51±0.52),(3.12±0.55),(3.07±0.28) and(3.14±0.61) points, which was higher than those of the control group(2.07±0.75),(2.13±0.14),(2.32±0.37) and(2.41±0.56) points, and the difference was statistically significant(P<0.05). The satisfaction score with treatment work of the research group was(91.1± 2.4) points, which was higher than that of the conventional group(82.7±3.7) points, and the difference was statistically significant(P<0.05). Conclusion Compared with traditional posterolateral and anteromedial approach, the improved posterolateral and anteromedial approach has more ideal therapeutic effects for patients with Cotton’s fracture, and can be used in clinical practice.