胫骨远端后侧多向锁定钢板在治疗旋后外旋型Ⅳ度踝关节骨折中的临床应用效果

Clinical Application of Multi-directional Locking Plate on the Posterior Side of the Distal Tibia in the Treatment of Supination and External Rotation TypeⅣAnkle Fractures

目的:研究胫骨远端后侧多向锁定钢板运用于旋后外旋型Ⅳ度踝关节骨折中的价值。方法:选择本院2019年1月-2020年12月收治的80例旋后外旋型Ⅳ度踝关节骨折患者,按随机数字表法分为两组,各40例,研究组开展胫骨远端后侧多向锁定钢板固定,对照组接受切开复位内固定。统计两组失血量;统计手术、消肿、疼痛消失、住院及骨折愈合时长;评价治疗结果的优良率;手术前、手术后4周进行视觉模拟(VAS)评分、踝关节(Mazur)评分、临床症状评分、生活质量(QOL)评分调查。结果:研究组失血量少于对照组,且手术、消肿、疼痛消失、住院及骨折愈合时长均短于对照组,差异有统计学意义(P<0.05);研究组优良率90.00%,高于对照组的72.50%,并发症发生率7.50%,低于对照组的27.50%,差异有统计学意义(P<0.05);手术后研究组VAS评分、临床症状评分低于对照组,Mazur评分高于对照组,差异有统计学意义(P<0.05);手术后研究组QOL各维度评分均高于对照组,差异有统计学意义(P<0.05)。结论:胫骨远端后侧多向锁定钢板固定治疗旋后外旋型Ⅳ度踝关节骨折患者的效果更好,可缓解临床症状与疼痛程度,改善踝关节功能,促进骨折愈合,缩短住院天数,提升生活质量。

Objective:To study the value of multi-directional locking plate on the posterior side of the distal tibia for supination and external rotation typeⅣankle fractures.Method:Eighty patients with supination and external rotation typeⅣankle fractures admitted to our hospital from January 2019 to December 2020 were selected and divided into two groups according to the random number table method,each with 40 cases.The study group carried out multi-directional locking plate on the posterior side of the distal tibia,and the control group received open reduction and internal fixation.The blood loss of the two groups was counted;the duration of surgery,swelling,pain disappearance,hospitalization and fracture healing were counted;the excellent and good rate of the treatment results was evaluated;visual analogue(VAS)score,ankle joint(Mazur)score,clinical practice before and 4 weeks after surgery symptom score and quality of life(QOL)score survey were compared.Result:The blood loss of the study group was less than that of the control group,and the duration of surgery,swelling,pain disappearance,hospitalization and fracture healing were shorter than those of the control group,the differences were statistically significant(P<0.05).The excellent and good rate of the study group was 90.00%,which was higher than 72.50%in the control group and the complication rate was 7.50%,which was lower than 27.50%in the control group,the differences were statistically significant(P<0.05).The VAS score and clinical symptom score of the study group after surgery were lower than those of the control group,while the Mazur score was higher than that in the control group,the differences were statistically significant(P<0.05).After the operation,the QOL scores of the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Multi-directional locking plate fixation on the posterior side of the distal tibia is more effective in treating patients with supination and external rotation typeⅣankle fractures,which can relieve clinical symptoms and pain,improve ankle function,promote fracture healing,and shorten hospital stays,improve the quality of life.