切开复位内固定联合带线锚钉修复在踝关节骨折合并三角韧带损伤中的应用效果分析

Effect of Open Reduction and Internal Fixation Plus Suture Anchor Repair in the Treatment of Ankle Fracture Complicated with Deltoid Ligament Injury

目的 探讨切开复位内固定(ORIF)联合带线锚钉修复在踝关节骨折合并三角韧带损伤中的应用效果。方法 选取2019年5月至2021年5月嵩县西关骨科医院收治的190例踝关节骨折合并三角韧带损伤患者作为研究对象,按照随机数表法将其随机分为观察组(95例)与对照组(95例),观察组患者采用ORIF联合带线锚钉修复治疗,对照组患者单纯采用ORIF治疗,对比观察两组患者内踝间隙、距骨倾斜角、疼痛情况、踝关节功能恢复情况与并发症发生情况。结果 术后3个月,观察组患者内踝间隙、距骨倾斜角均明显小于对照组(t=2.792、3.484,P=0.006、0.001),视觉模拟评分法(VAS)评分明显低于对照组(t=3.338,P=0.001);术后3个月,观察组患者踝关节功能恢复为优57例、良34例、可3例、差1例,明显优于对照组患者的踝关节功能恢复为优43例、良41例、可7例、差4例(Z=-2.289,P=0.022);观察组患者术后并发症发生率为4.21%,明显低于对照组患者的术后并发症发生率12.63%(χ^(2)=4.368,P=0.037)。结论 ORIF联合带线锚钉修复治疗踝关节骨折合并三角韧带损伤,可明显缩小内踝间隙及距骨倾斜角,促进踝关节功能恢复,降低术后并发症发生率。

Objective To analyze the effect of open reduction and internal fixation(ORIF) combined with suture anchor repair in the treatment of ankle fracture complicated with deltoid ligament injury.Methods 190 patients with ankle fracture and deltoid ligament injury admitted into Songxian Xiguan Orthopedic Hospital between May 2019 and May 2021were enrolled as research subjects,and divided into study group(n=95) and control group(n=95) using the random number table.Patients in the study group were treated with ORIF plus suture anchor repair,while patients were treated with ORIF alone in the control group.The media clear space,talar tilt angle,pain degree,functional recovery condition of ankle joint and occurrence of complications of patients were compared between the two groups.Results Three months after operation,the media clear space and talar tilt angle of patients were obviously smaller in the study group compared with the control group(t=2.792 and 3.484,P=0.006 and 0.001),and the visual analogue scale(VAS) score was markedly lower in the study group(t=3.338,P=0.001);the functional recovery of ankle joints were evaluated as excellent in 57cases,good in 34 cases,fair in 3 cases and poor in 1 case in the study group,which was obviously better than that in control group(Z=-2.289,P=0.022)-excellent in 43 cases,good in 41 cases,fair in 7 cases and poor in 4 cases.The incidence of postoperative complication of patients was 4.21% in the study group,being significantly lower than the corresponding 12.63% in the control group(χ~2=4.368,P=0.037).Conclusion The combined application of ORIF and suture anchor repair in the treatment of ankle fracture complicated with deltoid ligament injury can effectively shorten media clear space and talar tilt angle,promote the functional recovery of ankle joint,and decrease the incidence of postoperative complications.