缝合锚钉在踝关节骨折合并三角韧带完全断裂修复中的应用

Application of Suture Anchor in the Repair of Ankle Fracture complicated with Complete Rupture of Deltoid Ligament

【目的】探讨缝合锚钉在踝关节骨折合并三角韧带完全断裂修复中的临床应用价值。【方法】回顾性分析本院2015年1月至2020年1月收治的69例踝关节骨折合并三角韧带完全断裂患者的临床资料。按患者手术中是否应用缝合锚钉修复三角韧带深层,将其分为修复组(36例)和未修复组(33例)。对比两组术后1个月、术后6个月内侧间隙(MCS)、美国足踝外科协会踩后足评分(AOFAS)及疼痛视觉模拟评分(VAS)变化以及术后6个月踝关节活动度,评价两组临床疗效与安全性。【结果】两组术后6个月AOFAS评分均较术后1个月升高,VAS评分均较术后1个月下降,且修复组术后1个月、术后6个月MCS、VAS评分均低于未修复组,AOFAS评分高于未修复组;术后6个月,修复组踝关节趾屈、背伸角度均大于未修复组,临床优良率高于未修复组(86.11%vs 69.70%),其差异均有统计学意义(均P<0.05)。修复组术后并发症发生率为2.78%,低于未修复组的21.21%,差异有统计学意义(P<0.05)。【结论】缝合锚钉修复三角韧带深层能够促进踝关节骨折合并三角韧带完全撕裂患者术后踝关节功能恢复、减轻术后疼痛,降低术后复位不良等并发症风险,具有较好的临床应用价值。

【Objective】To investigate the clinical value of suture anchor in the repair of ankle fracture compli-catcd with complete rupture of deltoid ligament.【Methods】The clinical data of 69 patients with aiikle fracture combined with complete rupture of deltoid ligament in our hospital from January 2015 to January 2020 were retro spcctivcly analyzed.The patients were divided into the repair group(n=36)and the non-repair group(n=33)according to whether suture anchor was used to repair the deep deltoid ligament.The changes of medial space(MCS),American Association of foot and ankle surgeon's ankle-hindfoot score(AOFAS)and visual analogue scale(VAS)at 1 month and 6 months after operation,and the range of motion of ankle joint at 6 months after operation were compared between the two groups to evaluate the clinical efficacy and safety of the two groups.【Results】The AOFAS scores of the two groups at 6 months after operation were higher than those at 1 month after operation,while the VAS scores were lower than those at 1 month after operation.The MCS and VAS scores of the repair group at 1 month and 6 months after operation were lower than those of the non-repair group,and the AOFAS,scores were higher than those of the non-repair group.At 6 months after operation,the toe flexion and hack extension angles of the repair group were higher than those of the non repair group,and the clinical excellent and good rate was higher than that of the non-repair group(86.11%vs 69.70%).The differences were statistically significant(all P<0.05).The incidence of postoperative complications in the repair group was 2.78%,which was lower than 21.21% in the non repair group(P<0.05).【Conclusion】Suture anchor repair of deep deltoid ligament can promote ankle function recovery,reduce postoperative pain,and reduce the risk of postoperative complications such as poor reduction in patients with ankle fracture combined with complete tear cf deltoid ligament.