两种内固定术治疗踝关节骨折的疗效比较

Efficacy comparison of two kinds of internal fixation for treatment of ankle fracture

目的比较锁定钢板联合空心拉力螺钉与非锁定钢板联合普通螺钉内固定治疗踝关节骨折的疗效。方法将70例踝关节骨折患者根据治疗方法不同分为观察组(采用锁定钢板联合空心拉力螺钉内固定治疗,35例)和对照组(采用非锁定钢板联合普通螺钉内固定治疗,35例)。比较两组手术情况、骨折愈合情况、踝关节活动度、踝关节功能及并发症发生情况。结果患者均获得6个月随访。手术时间、住院时间、骨折愈合时间观察组均短(少)于对照组(P<0.05)。术中出血量、骨折愈合质量评分系统(RUSS评分)两组比较差异均无统计学意义(P>0.05)。术后3个月踝关节跖屈、背伸、内翻、外翻活动度观察组均大于对照组(P<0.05)。足部力线、地面步行、疼痛、最大步行距离评分:两组术后6个月均较术后3个月提高(P<0.05),术后3、6个月观察组均高于对照组(P<0.05)。并发症发生率观察组低于对照组(P<0.05)。结论与非锁定钢板联合普通螺钉相比,锁定钢板联合空心拉力螺钉内固定治疗踝关节骨折手术时间、住院时间、骨折愈合时间均较短,踝关节功能恢复较好,并发症较少。

Objective To compare the efficacy of locking plate combined with cannulated lag screw and non-locking plate combined with common screw internal fixation for treatment of ankle fracture.Methods The 70 patients with ankle fractures were divided into observation group(35 cases were treated with locking plate combined with cannulated lag screw internal fixation)and control group(35 cases were treated with non-locking plate combined with common screw internal fixation),according to different treatment methods.The operation situation,fracture healing status,ankle joint range of motion,joint function and complications were compared between the two groups.Results All patients were followed up for 6 months.The operation time,hospitalization time and fracture healing time in the observation group were shorter(less)than those in the control group(P<0.05).There were no statistical differences in intraoperative blood loss and the Radiographic Union Score for Tibial Fractures(RUSS scores)between the two groups(P>0.05).Three months after operation,the ankle of planter flexion,dorsiflexion,varus and valgus angles in the observation group were all greater than those in the control group(P<0.05).At 6 months postoperation,the scores of foot alignment,ground walking,pain and maximum walking distance in the two groups were all increased than those at 3 months after operation(P<0.05),and above data in the observation group were higher than those in the control group at 3,6 months after operation(P<0.05).The incidence rate of complications in the observation group was lower than that in the control group(P<0.05).Conclusions Compared with non-locking plate combined with common screw,locking plate combined with cannulated lag screw internal fixation have shorter operation time,hospitalization time and fracture healing time,better ankle function recovery and fewer complications.