手术治疗32例距骨颈骨折的疗效及经验分析

The curative effect and experience analysis of surgical treatment of 32 cases of talar neck fracture

目的:分析手术治疗距骨颈骨折的整体疗效。方法:2018年10月-2020年8月收治距骨颈骨折患者68例,随机分为两组。A组给予闭合复位治疗,术式为经皮后外侧-空心钛钉固定;B组给予切开复位治疗,术式为空心钛钉内固定。比较两组治疗效果。结果:A组手术时长、术中出血量、切口长度和住院天数均低于B组,差异有统计学意义(P<0.05);A组踝-足部功能优良率高于B组,且并发症发生率低于B组,差异均有统计学意义(P<0.05)。A组治疗3个月后的前后活动、稳定性、后足活动及足部对线评分均高于B组,差异有统计学意义(P<0.05)。结论:为距骨颈骨折患者实行经皮后外侧-空心钛钉固定治疗,可改善手术指标水平,恢复足-踝管功能,利于症状改善。

Objective:To analyze the overall curative effect of surgical treatment of talus neck fractures.Methods:From October 2018 to August 2020,68 patients with talar neck fracture were selected,they were randomly divided into the two groups.The group A was given closed reduction treatment.The operation was percutaneous posterolateral-hollow titanium nail fixation.The group B was given open reduction treatment with inner fixation with hollow titanium nail.We compared the treatment effects of the two groups.Results:The operation time,intraoperative blood loss,incision length and hospitalization days in the group A were lower than those in the group B,the difference was statistically significant(P<0.05).The excellent and good rate of ankle-foot function in the group A was higher than that in the group B,the incidence of complications was lower than that in the group B,the differences were statistically significant(P<0.05).After 3 months of treatment in group A,the scores of front and back activity,stability,hindfoot activity and foot alignment were higher than those of the group B,the difference was statistically significant(P<0.05).Conclusion:The percutaneous posterolateral-hollow titanium nail fixation treatment for patients with talar neck fractures can improve the level of surgical indicators,restore the function of the foot-ankle tube,and improve the symptoms.