支撑钢板联合空心螺钉治疗Herscovici D型内踝骨折的疗效观察

Effectiveness of buttress plate combined with cannulated screw for treatment of Herscovici D type medial malleolar fracture

目的:探讨支撑钢板联合空心螺钉治疗Herscovici D型内踝骨折的临床疗效。方法:回顾性分析某院骨科收治的36例踝关节骨折患者的临床资料,均存在Herscovici D型内踝骨折,依据治疗方案的不同分为观察组和对照组。对照组18例患者采用传统空心螺钉固定,观察组18例患者采用支撑钢板联合空心螺钉固定。比较术后2组患者骨折愈合时间、完全负重时间、复位丢失率、并发症发生率及术后12个月美国足踝外科协会踝与后足评分(AOFAS)。结果:36例患者均获得(14.2±1.6)个月随访;观察组骨折复位丢失率为5.6%,明显低于对照组的38.9%(P<0.05);观察组骨折愈合时间、完全负重时间小于对照组,术后12个月AOFAS评分观察组高于对照组,差异均有统计学意义(P<0.05);2组患者术后并发症发生率比较差异无统计学意义(P>0.05)。结论:支撑钢板联合空心螺钉治疗Herscovici D型内踝骨折具有固定牢靠、早期功能锻炼、加快康复、提高踝关节功能等优点,值得临床上推广应用。

Objective:To investigate the effectiveness of buttress plate combined with cannulated screw for the treatment of Herscovici D type medial malleolar fracture.Methods:Clinical data of 36 patients with ankle fracture who underwent surgery in a hospital were retrospectively analyzed,all of them including Herscovici D type medial malleolar fracture.18 of them were treated with traditional cannulated screw(control group),and the other 18 were treated with buttress plate combined with cannulated screw(observation group).Postoperative anteroposterior and lateral X-ray films were taken to evaluate fracture reduction and union condition.The two groups were compared in terms of complications,fracture healing time,full weight-bearing time,and loss of reduction.Ankle-hindfoot scores by the American Orthopaedic Foot and Ankle Society(AOFAS)were also used in the comparison 12 months after the surgery.Results:During the follow-up time,the bony union was observed according to X-rays in all patients.Less fracture healing time and full weight-bearing time of the observation group were recorded than those in the control group(P<0.05).The AOFAS scores of the observation group were better than those in the control group(P<0.05).There was no significant differences between the two groups as regards the incidence of complications(P>0.05).Conclusion:Buttress plate combined with cannulated screw for the treatment of Herscovici D type medial malleolus fracture has the advantages of firm fixation,early functional exercise of patients,faster recovery of patients,and improved ankle function.It is worthy of clinical application.