摘要
目的:通过临床对照研究,探讨组合式踝关节三维骨科牵引固定架治疗三踝骨折的临床疗效。方法:选取2009年1月-2013年7月收治的旋后-外旋型IV度及旋前-外旋型IV度三踝骨折患者80例,随机分为观察组和对照组,每组40例。观察组男21例,女19例;旋后-外旋型IV度28例,旋前-外旋型IV度12例;独立分型指导下闭合复位后组合式踝关节三维骨科牵引固定架固定治疗。对照组男19例,女21例;旋后-外旋型27例,旋前-外旋型13例;切开复位内固定治疗。采用主观评分、AOFAS评分及解剖评分对两组疗效进行评定。结果:术后半年对两组患者疗效进行评定,根据AOFAS评分,观察组优36例,良1例,一般3例,优良率为92.5%;对照组优33例,良5例,一般2例,优良率为95.0%,差异无统计学意义(P>0.05)。主观评分两组对比差异无统计学意义(P>0.05)。解剖评分对照组略高于观察组,两组对比差异有统计学意义(P<0.05)。结论:组合式踝关节三维骨科牵引固定架治疗三踝骨折方法安全、疗效确切,操作简便,关节功能康复满意,值得临床参考应用。
Objective.. Through the clinical controlled study to investigate the clinical result of the combined three-dimen- sional ankle tractional frame in treatment of trimalleolar fracture. Methods： Between January 2009 and July 2013, 80 pa- tients with supination external rotation and pronation external rotation trimalleolar fracture （grade Ⅳ ） were divided into the trial group and the control group randomly,40 patients in each group. The trial group, including 21 males and 19 fe- males, classified as pronation external rotation（ grade Ⅳ）in 12 cases and supination external rotation （grade Ⅳ ）in 28 ca- ses, was treated with the combined three-dimensional ankle tractional frame after closed reduction through independent classification guidance, The control group, including 19 males and 21 females, classified as pronation external rotation （grade I~ ） in 13 cases and supination external rotation （grade Ⅳ ） in 27 cases, was treated with the open reduction and in- ternal fixation. The effects of the two groups were evaluated according to the scores of AOFAS, subjectivity and anato- my. Results： The clinical efficacy of the two groups was evaluated six months after operation. According to the AOFAS scores, the total effective rate is 92.5% in trial group, excellent in 36 cases, good in i and fair in 3. And the total effec- tive rate is 95 % in control group, excellent in 33 cases, good in 5 and fair in 2. There was no significant difference in AO-FAS and subjective scores between two groups（P〉0. 05）. But the anatomical scores in control group is slightly higher than that of trial group, which shows significant difference （P〉0.05）. Conclusion： The combined three-dimensional an- kle tractional frame is safe and effective in the treatment of trimalleolar fracture, and worth to be popularized in clinic.
出处
《中国中医骨伤科杂志》
CAS
2015年第10期11-14,共4页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
基于筋束骨理论三踝骨折闭合复位机理的解剖和生物力学基础(2013年国家自然科学基金面上项目
81273785)
新型外固定架治疗三踝骨折及骨关节病的推广应用(2012年北京市科技委员会首都十大危险疾病科技成果推广项目
Z121100005512013)
关键词
三踝骨折
独立分型
外固定架
闭合复位
trimalleolar fracture
independent classificationexternal fixator
closed reduction
