手术与非手术治疗Ⅲ度踝外侧副韧带损伤的效果与安全性对比评价

Comparative Evaluation of the Efficacy and Safety of Surgical and Non-surgical Treatment ofⅢDegree Lateral Ankle Collateral Ligament Injury

目的:对比分析手术与非手术治疗Ⅲ度踝外侧副韧带损伤的效果与安全性,为临床上选择最佳方式治疗Ⅲ度急性踝关节外侧副韧带损伤提供必要的理论依据。方法:选取2019年3月-2020年2月收治的106例急性Ⅲ度踝外侧副韧带损伤患者,按治疗方式分为手术组和非手术组,各53例。手术组给予韧带解剖修复术,非手术组给予石膏内固定治疗。比较两组治疗后3、6、12个月临床效果、AOFAS评分及随访期间并发症发生情况。结果:治疗前,两组AOFAS评分比较,差异无统计学意义(P>0.05);治疗后3、6、12个月,两组AOFAS评分均呈上升趋势,并且手术组治疗后3、6、12个月AOFAS评分均较非手术组上升幅度更显著(P<0.05)。治疗后3、6、12个月,手术组临床优良率分别为75.47%、86.79%、96.23%,较非手术组的56.60%、75.47%、84.91%均显著提高(P<0.05)。治疗后随访12个月,两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:手术治疗Ⅲ度急性踝关节外侧副韧带损伤可提高临床效果,改善患者踝关节功能,并且安全、可靠,可在临床上推广,但要把握好手术的时机,及早明确诊断。

Objective:To compare and analyze the efficacy and safety of surgical and non-surgical treatment ofⅢdegree lateral ankle collateral ligament injury,and to provide the necessary theoretical basis for choosing the best clinical method for the treatment of third-degree acute lateral ankle collateral ligament injury.Method:A total of 106 patients with acute degree of malleolateral collateral ligament injury admitted to our hospital from March 2019 to February 2020 were selected,they were divided into the surgical group and non-surgical group according to the treatment methods,with 53 patients in each group.The surgical group was given anatomical ligament repair,and the non-surgical group was given plaster internal fixation.Clinical efficacy,AOFAS score at 3,6 and 12 months after treatment and complications during follow-up were compared between the two groups.Result:Before treatment,there was no significant difference in AOFAS scores between the two groups(P>0.05);at 3,6 and 12 months after treatment,AOFAS scores in both groups showed an upward trend,and the increase rates of AOFAS scores in the surgical group were more significant than those in the non-surgical group(P<0.05).At 3,6 and 12 months after treatment,the excellent and good rates of the surgical group were 75.47%,86.79%and 96.23%,respectively,which were significantly higher than 56.60%,75.47%and 84.91%of the non-surgical group(P<0.05).After 12 months of follow-up,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Surgical treatment ofⅢdegree of acute lateral collateral ligament injury of the ankle joint can improve the clinical effect,improve the function of the patient’s ankle joint,and safe,reliable,can be promoted in clinical practice,but we should grasp the timing of surgery,early diagnosis.