下胫腓韧带修复术联合螺钉固定术治疗踝关节骨折合并下胫腓联合韧带损伤患者的效果

Effects of inferior tibiofibular ligament repair combined with screw fixation in treatment of ankle fracture combined with inferior tibiofibular ligament injury

目的:观察下胫腓韧带修复术联合螺钉固定术治疗踝关节骨折合并下胫腓联合韧带损伤患者的效果。方法:回顾性分析2021年10月至2023年10月西安市阎良区中医医院收治的80例踝关节骨折合并下胫腓联合韧带损伤患者的临床资料,按照手术方法不同将其分为对照组和观察组各40例。对照组实施下胫腓螺钉固定术治疗,观察组在对照组基础上联合下胫腓韧带修复术治疗。比较两组手术优良率,手术前后疼痛[视觉模拟评分法(VAS)]、踝关节功能[美国足踝外科协会(AOFAS)踝-后足]评分,以及并发症发生率。结果:观察组手术优良率为92.50%(37/40),高于对照组的75.00%(30/40),差异有统计学意义(P<0.05);术后1、2个月,两组VAS评分均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);术后2个月,两组AOFAS踝-后足评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.00%(2/40),低于对照组的22.50%(9/40),差异有统计学意义(P>0.05)。结论:下胫腓韧带修复术联合螺钉固定术治疗踝关节骨折合并下胫腓联合韧带损伤患者可提高手术优良率和踝关节功能评分,降低疼痛评分和并发症发生率,效果优于单纯下胫腓螺钉固定术治疗。

Objective:To observe effects of inferior tibiofibular ligament repair combined with screw fixation in treatment of ankle fracture combined with inferior tibiofibular ligament injury.Methods:The clinical data of 80 patients with ankle fracture combined with inferior tibiofibular ligament injury admitted to Xi’an Yanliang District Hospital of Traditional Chinese Medicine from October 2021 to October 2023 were retrospectively analyzed.According to different surgical methods,they were divided into control group and observation group,40 cases in each group.The control group was treated with inferior tibiofibular screw fixation,while the observation group was treated with inferior tibiofibular ligament repair on the basis of that of the control group.The excellent and good rate of surgery,the scores of pain[visual analogue scale(VAS)]and ankle function[American orthopaedic foot and ankle society(AOFAS)ankle-hindfoot]before and after the surgery,and the incidence of complications were compared between the two groups.Results:The excellent and good rate of surgery in the observation group was 92.50%(37/40),which was higher than 75.00%(30/40)in the control group,and the difference was statistically significant(P<0.05).1 and 2 months after the surgery,the VAS scores of the two groups were lower than those before surgery,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).2 months after the surgery,the AOFAS ankle-hindfoot scores of the two groups were higher than those before surgery,that in the observation group was higher than that in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 5.00%(2/40),which was lower than 22.50%(9/40)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Inferior tibiofibular ligament repair combined with screw fixation in the treatment of ankle fracture combined with inferior tibiofibular ligament injury can improve the excellent and good rate of surgery and the ankle function scores and reduce the pain scores and the incidence of complications.Moreover,it is superior to simple inferior tibiofibular screw fixation.