抗滑钢板内固定治疗后踝关节骨折疗效分析

Clinical Efficacy of Anti-sliding Plate Fixation in the Treatment of Posterior Malleolar Fracture

目的 探讨抗滑钢板内固定治疗后踝关节骨折的临床疗效方法 选取2018年6月至2019年6月息县人民医院收治的102例后踝关节骨折患者作为研究对象,按照不同治疗方式将其分为抗滑钢板组(72例)和空心钉组(30例),抗滑钢板组患者行抗滑钢板内固定治疗,空心钉组患者行空心钉内固定治疗,对比两组患者踝关节功能恢复情况、疼痛程度、临床疗效以及术后并发症发生情况。结果 术后6个月,抗滑钢板组患者美国矫形外科足踝协会(AOFAS)踝-后足评分为(85.16±4.38)分,明显高于空心钉组患者的AOFAS踝-后足评分(78.15±4.04)分(t=7.530.P<0.001),视觉模拟评分法(VAS)评分为(1.52±0.30)分,明显低于空心钉组患者的VAS评分(3.28±0.31)分(t=26.740,P<0.001);抗滑钢板组患者中优36例、良26例、可7例、差3例,明显优于空心钉组患者的优10例、良9例、可6例、差5例(Z=-2.262,P=0.024)其间,抗滑钢板组患者术后并发症发生率为8.33%,明显低于空心钉组患者的术后并发症发生率23.33%(χ^(2)=4.285,P=0.038)结论 与空心钉内固定相比,抗滑钢板内固定可明显提高后踝关节骨折患者术后踝关节功能恢复效果,减轻患者疼痛程度,降低术后并发症发生率,疗效更显著。

Objective To analyze the clinical efficacy of internal fixation with anti-sliding plate in the treatment of posterior malleolar fracture.Methods 102 patients with posterior malleolar fracture,admitted to Xixian People’s Hospital from June 2018 to June 2019,were enrolled and divided into anti-sliding plate group(n=72) receiving anti-sliding plate fixation,and hollow screw group(n=30) receiving hollow screw fixation.Functional recovery of ankle joint,pain degree,clinical efficacy and occurrence of postoperative complications were compared between the two groups.Results Six month after surgery,the American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score of patients was(85.16±4.38) points in anti-sliding plate group,obviously higher than(78.15±4.04) points in hollow screw group(t=7.530,P <0.001),while visual analogue scale(VAS) score was(1.52±0.30) points,significantly lower than(3.28±0.31)points in hollow screw group(t=26.740,P <0.001).As for the clinical efficacy,36 cases were evaluated as excellent,26 as good,7 as fair and 3 as poor in anti-sliding plate group,which was obviously superior to hollow screw group(Z=-2.262,P=0.024)-10 as excellent,9 as good,6 as fair and 5 as poor.During the course of treatment,the incidence of postoperative complications was 8.33% in anti-sliding plate group,markedly lower than 23.33% in hollow screw group(χ^(2)=4.285,P=0.038).Conclusion Compared with hollow screw fixation,anti-sliding plate fixation is better in improving ankle functional recovery of patients with posterior malleolar fracture,relieving their pain and decreasing incidence of postoperative complications,and the clinical efficacy was more definite.