经外踝骨折间隙清理后复位内固定术在踝关节旋后外旋型Ⅲ、Ⅳ度骨折患者中的应用效果

Application effect of reduction and internal fixation after clearance of the trans-ankle fracture gap in patients with posterior external rotation typeⅢandⅣfractures

目的探讨经外踝骨折间隙清理后复位内固定术在踝关节旋后外旋型Ⅲ、Ⅳ度骨折患者中的应用效果。方法回顾性选取2015年1月至2020年3月广州医科大学附属第六医院收治的50例踝关节旋后外旋Ⅲ、Ⅳ度患者作为研究对象,按照骨折不同治疗方法分为A组(32例)和B组(18)例。A组采取经外踝骨折间隙清理后复位内固定术,B组采用传统切开复位内固定术。比较两组的手术时间,术中出血量、后踝复位质量及踝关节的功能评分。结果A组患者的手术时间为(76.8±8.7)min,短于B组的(82.6±9.5)min,差异有统计学意义(P<0.05);A组患者的术中出血量为(31.1±6.9)ml,与B组的(30.2±5.4)ml比较,差异无统计学意义(P>0.05);A组获得解剖复位率高于B组,差异有统计学意义(P<0.05);A组患者的踝关节功能优于B组,差异有统计学意义(P<0.05)。结论经外踝骨折间隙清理后,后踝骨折复位容易,解剖复位率高,改善踝关节术后功能,临床效果满意。

Objective To investigate the effect of reduction and internal fixation after clearance of the trans-ankle fracture gap in patients with posterior external rotation typeⅢandⅣfractures.Methods A total of 50 patients with typeⅢandⅣfracture were admitted to the Sixth Hospital of Guangzhou Medical University during January 2015 to March 2020,which were retrospectively divided into 32 cases in group A and 18 cases in group B according to different treatment methods of fracture.Group A was adopted in the repositioning and fixation of posterior ankle fracture,while Group B was adopted traditional open reduction and internal fixation.The operative time,intraoperative blood loss,quality of posterior ankle reduction and functional scores of the ankle joint were compared between two groups.Results The operative time of group A was(76.8±8.7)min,shorter than that of group B(82.6±9.5)min,and the difference was statistically significant(P<0.05).The intraoperative blood loss in group A was(31.1±6.9)ml,group B was(30.2±5.4)ml,and there was no significant different between two groups(P>0.05).The anatomical reduction rate in group A was higher than that in group B,and the difference was statistically significant(P<0.05).The ankle joint function of group A was better than that of group B,and the difference was statistically significant(P<0.05).Conclusion After the clearance of the external ankle fracture gap,the posterior ankle fracture is easily repositioned with high anatomical repositioning rate,and the postoperative function of the ankle joint can be improved with satisfactory clinical results.