后外侧手术入路联合体位改变用于三踝骨折患者内固定手术中的效果分析

Analysis of the Effect of Posterolateral Surgical Approach Combined with Positional Change in Internal Fixation for Patients with Trimalleolar Frac⁃ture

目的 探讨后外侧手术入路联合体位改变用于三踝骨折患者内固定手术中的效果。方法 回顾性选取2023年1—12月莆田九十五医院收治的82例三踝骨折患者的临床资料,根据手术入路不同分为两组,各41例。两组均实施切开复位内固定术,对照组选择传统入路配合仰卧位,研究组选择后外侧手术入路配合体位改变。对比两组的手术情况、术后并发症、术后恢复时间、踝关节功能评分、生活质量评分。结果 研究组手术时间、术后恢复时间(卧床、住院及骨折愈合的时间)均短于对照组,术中失血量低于对照组,差异有统计学意义(P均<0.05)。研究组的并发症总发生率为2.44%(1/41),低于对照组的19.51%(8/41),差异有统计学意义(χ^(2)=4.493,P<0.05)。术后,研究组的踝关节功能评分和生活质量评分均高于对照组,差异有统计学意义(P均<0.05)。结论 在三踝骨折患者切开复位内固定术中,选择后外侧手术入路配合体位改变,能够减轻手术创伤,减少术后并发症,加快术后康复,改善踝关节功能、生活质量。

Objective To explore the effect of posterolateral surgical approach combined with positional change in in⁃ternal fixation of patients with trimalleolar fracture.Methods The clinical data of 82 patients with trimalleolar fracture admitted to Putian 95 Hospital from January to December 2023 were retrospectively selected.They were divided into two groups according to different surgical approaches,41 cases in each group.Both groups were treated with open re⁃duction and internal fixation.The control group was treated with traditional approach combined with supine position,and the study group was treated with posterolateral surgical approach combined with position change.The operation condition,postoperative complications,postoperative recovery time,ankle function score and quality of life score were compared between the two groups.Results The operation time and postoperative recovery time(bed rest,hospitaliza⁃tion and fracture healing time)in the study group were shorter than those in the control group,and the intraoperative blood loss was lower than that in the control group,the differences were statistically significant(all P<0.05).The total incidence of complications in the study group was 2.44%(1/41),which was lower than 19.51%(8/41)in the control group,and the difference was statistically significant(χ^(2)=4.493,P<0.05).After operation,the ankle function score and quality of life score of the study group were higher than those of the control group,and the differences were statisti⁃cally significant(both P<0.05).Conclusion In the open reduction and internal fixation of patients with trimalleolar fractures,the choice of posterolateral surgical approach combined with postural changes can reduce surgical trauma,reduce postoperative complications,accelerate postoperative rehabilitation,and improve ankle function and quality of life.