后踝骨骨折块固定术治疗 Ⅲ、Ⅳ型踝关节骨折临床疗效

Clinical Effect of TypeⅢandⅣAnkle Fracture with Posterior Ankle Fracture Block Fixation

目的探讨采用后踝骨骨折块固定术治疗Ⅲ、Ⅳ型踝关节骨折的临床疗效.方法将186例Ⅲ、Ⅳ型踝关节骨折患者随机分为实验组(93例)和对照组(93例).实验组患者采用后踝骨骨折块固定治疗,即先行后踝骨骨折块固定,然后再行内外踝固定;对照组采用常规手术方法治疗,即先行内外踝固定,然后对后踝进行手法闭合复位,评价两种手术方法的临床疗效.结果实验组Phil-lips踝关节功能评分及骨骼愈合时间均优于对照组(t=6.319,t=9.653,P<0.01);实验组愈合优良率(92.47%)明显优于对照组(78.49%)(χ2=10.755,P<0.01);实验组患者术后1、3、6、12个月AOFAS踝-后足评分均优于对照组(t=6.936,P<0.01).结论后踝骨骨折块固定术治疗Ⅲ、Ⅳ型踝关节骨折可明显提高患者术后治疗效果,且患者的踝关节、后足功能恢复更好.

Objective To study the clinical effect of posterior ankle fracture block fixation in the treatment of typeⅢandⅣankle fracture.Method 186 patients with typeⅢandⅣankle fractures were randomly divided into the experimental group(93 cases)and the control group(93 cases),the patients in the experimental group were treated with posterior malleolus fracture block fixation,posterior malleolus fracture block fixation,and then internal and external malleolus fixation.The control group was treated by conventional operation,fixed the internal and external malleolus,then closed and reduced the posterior malleolus.The clinical effect of the two methods were evaluated.Results The ankle function score and bone healing time of the experimental group were better than those of the control group(t=6.319,t=9.653;P<0.01);The excellent rate of healing was 92.47%in the experimental group and 78.49%in the control group.The results of the experimental group were significantly better than those of the control group(χ2=10.755,P<0.01);AOFAS ankle foot score of the experimental group was 1 month,3 months,6 months and 12 months after operation.It was better than the control group(t=6.936,P<0.01).Conclusion The treatment of typeⅢandⅣankle fractures with posterior ankle fracture block fixation can significantly improve the postoperative treatment effect of patients,and the recovery of ankle joint and hind foot function of patients is better.