修复与不修复三角韧带治疗旋后-外旋Ⅳ型踝关节骨折的临床疗效

Clinical Effect of Repairing or Not Repairing the Triangular Ligament in the Treatment of Supination-external Rotation Type Ⅳ Ankle Fractures

目的探讨对旋后-外旋Ⅳ型踝关节骨折患者采用修复以及不修复三角韧带方法进行治疗后获得的临床效果。方法方便选取该院2016年5月-2019年1月收治的44例旋后-外旋Ⅳ型踝关节骨折患者,按数字奇偶法分组,治疗组(22例)采用术中修复三角韧带方法展开治疗,对照组(22例)采用术中不修复三角韧带方法进行治疗,就组间术中失血量、临床手术时长、VAS评分、AOFAS评分、骨折愈合时长等展开对比。结果治疗组术中失血量为(83.36±6.43)mL;临床手术时长为(148.89±7.36)min,与对照组(80.77±4.75)mL、(147.23±3.69)min比较,差异无统计学意义(t=1.520、0.946,P>0.05);术前,治疗组VAS评分为(6.31±1.15)分、AOFAS评分为(48.46±6.89)分,对照组分别为(6.42±1.07)分、(48.52±5.91)分,组间差异无统计学意义(P>0.05);术后治疗组VAS评分为(1.99±0.85)分、AOFAS评分为(90.35±5.71)分,术后对照组分别为(2.02±1.02)分、(89.22±6.55)分,组间差异无统计学意义(P>0.05);治疗组骨折愈合时长为(13.96±2.35)周,对照组为(14.02±3.56)周,组间差异无统计学意义(t=0.066,P>0.05);两组患者均表现出切口Ⅰ期愈合,未表现出骨折不愈合、伤口感染、下肢深静脉血栓以及创伤性关节炎等现象。结论旋后-外旋Ⅳ型踝关节骨折患者在接受治疗期间,对于三角韧带修复或者不修复,均可获得较为理想的治疗效果。

Objective To investigate the clinical results obtained after treatment with and without repairing the triangular ligament in patients with supination-external rotation typeⅣankle fractures.Methods The 44 cases of supination-external rotation typeⅣankle fracture patients admitted to the hospital from May 2016 to January 2019 were conveniently selected and divided into groups by the digital parity method.The treatment group(22 cases)was treated with intraoperative repair of the deltoid ligament;the control group;(22 cases)were treated with the method of not repairing the deltoid ligament during the operation,and the intraoperative blood loss,clinical operation time,VAS score,AOFAS score,fracture healing time,etc.were compared between groups.Results The intraoperative blood loss in the treatment group was(83.36±6.43)mL,and the clinical operation time was(148.89±7.36)min.Compared with the control group,the intraoperative blood loss was(80.77±4.75)mL and the clinical operation time was(147.23±3.69)min.The difference was not statistically significant(t=1.520,0.946,P>0.05).before the operation,the VAS score of the treatment group was(6.31±1.15)points,the AOFAS score was(48.46±6.89)points,and the control group were(6.42±1.07)points,(48.52±5.91)points,there was no significant difference between the groups(P>0.05);the VAS score of the postoperative treatment group was(1.99±0.85)points,the AOFAS score was(90.35±5.71)points,and the postoperative control group were(2.02±1.02)points,(89.22±6.55)points,the difference between the groups was not statistically significant(P>0.05);the fracture healing time of the treatment group was(13.96±2.35)weeks,and the control group was(14.02±3.56)weeks,the difference between the groups wasnot statistical significance(t=0.066,P>0.05);both groups of patients showed first-stage healing of incisions,but did not show non-union of fractures,wound infection,deep vein thrombosis of lower extremities,and traumatic arthritis.Conclusion During treatment,patients with supination-external rotation type IV ankle fractures can obtain relatively ideal short-term treatment results for the repair of the deltoid ligament or not.