对比经腓骨后外侧入路和经腓骨入路内固定术治疗旋后外旋型Ⅳ度踝关节骨折的效果

Comparison of Fibula Posterolateral Approach and Fibula Approach for Internal Fixation of Supination External Rotation Type Ⅳ Degree Ankle Joint

目的 对比旋后外旋型Ⅳ度踝关节骨折内固定术治疗中经腓骨后外侧入路、经腓骨入路的效果。方法 筛选2014年1月—2022年12月昆山市第四人民医院收治的旋后外旋型Ⅳ度踝关节骨折患者50例为研究对象,并按照计算机法划分对照组、观察组,每组25例。对照组经腓骨入路、观察组经腓骨后外侧入路,均行内固定术治疗。对比两组临床指标、并发症发生率和踝关节功能恢复情况。结果 观察组术中出血量、切口长度低于对照组,手术时间、住院时间和骨折愈合时间均短于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。术后3个月、6个月时,观察组踝关节功能评分均高于对照组(P<0.05)。结论 经腓骨后外侧入路内固定术是旋后外旋型Ⅳ度踝关节骨折病人理想的手术方式,相较于经腓骨入路创伤更小、安全性更高,有利于患者踝关节功能、活动度的恢复。

Objective To compare the effect of internal fixation in the treatment of medial fibula posterolateral approach and fibula approach for Ⅳ degree ankle fracture with supination external rotation.Methods The patients with Ⅳ degree ankle fracture of supination external rotation treated in Kunshan Fourth People's Hospital from January 2014 to December 2022 were selected as the objects,and 50 of them were included for analysis.The control group and observation group were divided into 25 cases by computer method.The control group and observation group were treated by internal fixation via fibular approach and posterolateral fibular approach.The clinical indexes,complication rate and ankle joint function recovery were compared between the two groups.Results The intraoperative blood loss and incision length in the observation group were lower than those in the control group,and the operation time,hospital stay and fracture healing time were shorter than those in the control group,with statistical significance(P<0.05).The complication rate of the observation group was higher than that of the control group(P< 0.05),and the ankle joint function score of the observation group was higher than that of the control group at three and six months after operation(P<0.05).Conclusion Fibula posterolateral approach is an ideal surgical method for patients with retroflex Ⅳ degree ankle fractures,which is less invasive and safer than fibular approach,and is beneficial to the ankle of patients recovery of joint function and range of motion.