摘要
目的比较踝关节骨折合并三角韧带断裂时,修复与不修复三角韧带对临床预后的影响。方法回顾性分析2009年3月至2015年12月西安交通大学医学院附属红会医院足踝外科收治的74例踝关节骨折合并三角韧带断裂的患者资料,其中修复组20例,未修复组54例。比较两组患者术前、术后内踝间距(MCS)及其复位不良率、失败率、美国足踝外科协会(AOFAS)踝-后足评分、疼痛视觉模拟评分(VAS),以及两组中AO分型B、C型的预后。结果两组患者术前一般资料与随访时间[(46.9±22.5)个月和(56.3±23.9)个月]比较差异均无统计学意义(P>0.05),具有可比性。修复组术后MCS[(3.3±0.3)mm]及末次随访时MCS[(3.2±0.3)mm]均小于未修复组[(3.8±1.0)mm和(3.8±1.2)mm],修复组复位不良率(0)低于未修复组(20.4%),差异均有统计学意义(P<0.05)。两组患者的手术失败率(0和7.4%)、AOFAS踝-后足评分[(88.0±5.8)分和(85.9±8.7)分]及VAS评分[(1.2±0.8)分和(1.6±1.6)分]比较差异均无统计学意义(P>0.05)。未修复组C型骨折复位不良率(41.2%)高于修复组B、C型和未修复组B型(0、0和10.8%),差异均有统计学意义(P<0.05)。结论手术修复三角韧带可以降低MCS的复位不良率,尤其是AOC型骨折。
Objective To compare the outcomes of surgical treatment of ankle fracture with or without repair of deltoid ligament (DL) rupture. Methods Between March 2009 and December 2015, 75 patients were treated surgically at Department of Foot and Ankle Surgery, Honghui Hospital for ankle fracture with DL rupture.Of them, the DL rupture was repaired in 20 (repair group) and not in 54 (non-repair group). The 2 groups were compared in terms of pre- and post-operative medial clear space (MCS), rate of radiological MCS malreduction (MCS>5 mm), rate of surgical failure, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS).The outcomes of AO/OTA types B and C were also compared between the 2 groups. Results The 2 groups were compatible due to insignificant differences in their preoperative general data and follow-up time (46.9±22.5 months versus 56.3±23.9 months)(P>0.05).The MCSs after operation (3.3±0.3 mm) and at the last follow-up (3.2±0.3 mm) in the repair group were significantly shorter than those in the non-repair group (3.8±1.0 mm and 3.8±1.2 mm)(P<0.05).The rate of radiological MCS malreduction in the repair group (0) was significantly lower than that in the non-repair group (20.4%)(P<0.05).There were no significant differences between the 2 group in rate of surgical failure (0 versus 7.4%), AOFAS ankle-hindfoot score (88.0±5.8 versus 85.9±8.7) or VAS (1.2±0.8 versus 1.6±1.6)(P>0.05).The rate of radiological MCS malreduction for AO/OTA type C ankle fracture in the non-repair group was significantly higher than those for AO/OTA types B and C in the repair group and AO/OTA type B in the non-repair group (P<0.05). Conclusion Surgical repair of the DL rupture may help decrease the rate of postoperative MCS malreduction, especially for AO/OTA type C ankle fractures.
作者
赵宏谋
梁景棋
张言
鹿军
李毅
温晓东
郝定均
梁晓军
Zhao Hongmou;Liang Jingqi;Zhang Yan;Lu Jun;Li Yi;Wen Xiaodong;Hao Dingjun;Liang Xiaojun(Department of Foot and Ankle Surgery, Honghui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an 710054, China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2019年第4期290-295,共6页
Chinese Journal of Orthopaedic Trauma
基金
中国博士后基金面上项目(2017M613178)
陕西省博士后基金(2017BSHQYXMZZ13)。
关键词
踝关节
骨折
三角切带
内踝间隙
Ankle
Fractures, bone
Deltoid ligament
Medial clear space
