克氏针联合PEEK锚钉治疗WagstaffeⅡ型骨折

Kirschner wire combined with PEEK anchor for the treatment of WagstaffeⅡfracture

目的:探讨采用克氏针联合PEEK带线锚钉固定WagstaffeⅡ型骨折中腓骨骨块的临床疗效。方法:自2018年1月至2020年12月,采用克氏针固定腓骨撕脱骨块,PEEK带线锚钉修复加固,石膏外固定治疗29例踝关节WagstaffeⅡ型骨折,男18例,女11例;年龄27~69(46.3±10.2)岁;均为单侧手术;左踝10例,右踝19例;受伤至手术时间3~5(4.05±0.63)d。分别于术前及术后6个月采用美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)的踝-后足功能评分系统和疼痛视觉模拟评分法(visual analogue scale,VAS)进行临床疗效评价。结果:29例患者均获得随访,时间6~12(9.7±2.1)个月。术后2例行走时出现踝关节疼痛,加强康复锻炼及消炎镇痛药物治疗后缓解。AOFAS评分由术前的(62.16±19.73)分提高至术后6个月的(91.35±6.37)分(t=5.51,P<0.01);其中优15例,良12例,一般2例。VAS由术前的(5.91±1.57)分降至术后6个月的(0.41±0.37)分(t=10.54,P<0.01)。结论:采用克氏针联合PEEK锚钉固定WagstaffeⅡ型骨折的腓骨骨折块,加强修复了下胫腓联合韧带和距腓前韧带,术后有效缓解踝关节疼痛症状,功能恢复良好,撕脱骨折块固定稳妥,可获得良好的临床疗效。

Objective:To explore clinical effect of Kirschner wire combined with PEEK anchor with thread to fix fibula bone block in WagstaffeⅡfracture. Methods:From January 2018 to December 2020,29 patients with WagstaffeⅡfracture of ankle joint were treated with Kirschner wire fixation of avulsed fibular bone block,PEEK with thread anchor repair and reinforcement,and plaster external fixation,including 18 males and 11 females,aged from 27 to 69 years old with an average of(46.3±10.2) years old. All of them were unilateral operations,and the time from injury to operation ranged from 3 to 5 days with an average of(4.05±0.63) days. Clinical efficacy was evaluated by using American Orthopedic Foot and Ankle Society(AOFAS) ankle-hindfoot functional scoring system and visual analogue scaleat scoring system before and after operation at 6 months. Results:All patients were followed up from 6 to 12 months with an average of(9.7±2.1) months. Two patients occurred pain of ankle joint during walking,which was relieved after strengthening rehabilitation exercise and anti-nflammatory and analgesic drug treatment. AOFAS score was incrased from(62.16±19.73) preoperativyly to(91.35±6.37) at 6 months after operation(t=5.51,P<0.01);15 patients got excellent results,12 moderate and 2 good. VAS was decreased(5.91±1.57) preoperativly to(0.41±0.37) at 6 months after operation(t=10.54,P<0.01). Conclusion:Kirschner wire combined with PEEK anchor with thread to fix fibula bone block in Wagstaffe Ⅱfracture strengthen repair of inferior tibiofibular syndesmosis ligament and anterior talofibular ligament,and effectively relieved ankle joint pain,obtain good function recovery,the avulsion fracture block was fixed securely,and receive good clinical effect.