解剖钢板固定术治疗创伤性后踝骨折的效果及对患者踝关节活动度和足踝功能的影响

Therapeutic effect of anatomical steel plate fixation surgery on traumatic posterior ankle fractures and its influence on motion range and function of ankle joint

目的分析解剖钢板固定术治疗创伤性后踝骨折的效果及对患者踝关节活动度、足踝功能的影响。方法队列研究。抽取2021年8月至2023年8月陕西中医药大学第二附属医院收治的86例创伤性后踝骨折患者,按随机数字表法分为对照组和观察组,每组43例。对照组行空心螺钉内固定术,观察组行解剖钢板固定术。比较两组手术相关指标、踝关节活动度、足踝功能及并发症发生率。结果观察组术中出血量[(96.47±9.68)mL]多于对照组[(75.63±7.59)mL],手术时间[(116.84±12.47)min]长于对照组[(94.72±10.21)min],骨折愈合时间[(11.25±1.29)周]短于对照组[(12.83±1.63)周],P<0.05;术后,观察组踝关节各活动度与美国足踝外科医生协会评分系统评分均高于对照组(P均<0.05);两组住院时间、并发症发生率比较差异未见统计学意义(P>0.05)。结论与空心螺钉内固定术比较,解剖钢板固定术的创伤较大,手术时间较长,但更能提高创伤性后踝骨折患者的踝关节活动度,促进足踝功能恢复,且无严重并发症。

Objective To analyze the effect of anatomical steel plate fixation surgery on traumatic posterior ankle fractures and its influence on motion rage and function of ankle joint.Methods A total of 86 patients with traumatic ankle fractures admitted to the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from August 2021 to August 2023 were selected for the cohort study.And they were divided into the control group and the observation group using a random number table method,with 43 cases in each group.The control group underwent hollow screw internal fixation surgery,while the observation group underwent anatomical steel plate fixation surgery.The surgical related indicators,motion range of ankle,foot and ankle function,and incidence of complications were compared between the two groups.Results The intraoperative blood loss in the observation group was(96.47±9.68)mL,which was higher than the(75.63±7.59)mL in the control group(P<0.05);while the operation duration in the observation group was(116.84±12.47)min,longer than the(94.72±10.21)min in the control group(P<0.05);the fracture healing time in the observation group was(11.25±1.29)weeks,shorter than the(12.83±1.63)weeks in the control group(P<0.05).After treatment,motion range of ankle joint,score of American Association of Foot and Ankle Surgeons scoring system in all dimensions in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the length of hospital stay and incidence of complication between the two groups(P>0.05).Conclusions Compared with hollow screw internal fixation,anatomical steel plate fixation has greater trauma and longer operation duration,but it can improve motion range of ankle joint better and promote ankle function recovery in patients with traumatic posterior ankle fractures,which has no severe complication.