摘要
[目的]比较内侧与外侧微创钢板固定胫骨螺旋骨折伴Hamguchil型后踝骨折的临床疗效。[方法]回顾性分析2014年6月-2019年12月本院手术治疗的64例胫骨螺旋骨折伴Haraguchi I型后踝骨折患者。按术前医患沟通结果,32例采用内侧钢板空心钉固定,32例采用外侧钢板空心钉固定。比较两组患者围手术期、随访及影像学相关资料。[结果]两组患者均顺利完成手术,未发生严重并发症。内侧组手术切口总长度、术中出血量和手术时间均显著优于外侧组(P<0.05)。64例患者术后随访12个月以上,两组恢复完全负重活动时间的差异均无统计学意义(P>0.05)。随术后时间推移,两组患者VAS评分显著减少(P<0.05),踝屈伸ROM,A0FAS评分显著增加(P<0.05)。相应时间点,两组间VAS评分、踝屈伸ROM、A0-FAS评分的差异均无统计学意义(P>0.05)。影像学方面:两组骨折复位质量、骨折愈合时间的差异均无统计学意义(P>0.05)。[结论]内侧与外侧钢板联合空心螺钉固定均可有效治疗胫骨螺旋骨折伴Haraguchi Ⅰ型后踝骨折,相比之下,内侧钢板手术创伤更小。
[Objective]To compare the clinical outcomes of medial minimal invasive plate versus lateral counterpart for tibial spiral fractures accompanied with Haraguchi type I posterior malleolus fractures.[Methods]A retrospective study was conducted on 64 patients who received surgical treatment for spiral tibial fractures accompanied with Haraguchi type I posterior malleolus fractures in our hospital from June 2014 to December 2019.According to the consequence of preoperative doctor-patient communication,32 patients underwent the medial plate combined with cannulated screws,while the remaining 32 patients received the lateral plate with cannulated screw.The perioperative,follow-up and imaging documents were compared between the two groups.[Results]Patients in both groups had operation performed successfully without serious complications.The medial group proved significantly superior to the lateral group in terms of total incision length,intraoperative blood loss and operation time(P<0.05).All patients were followed up for more than 12 months after operation.There was no significant difference in the time to resume full weight-bearing activity between the two groups(P>0.05).As time went post-operatively,the VAS scores decreased significantly(P<0.05),while the ankle flexion-extension range of motion(ROM)and AOFAS scores increased significantly in both groups(P<0.05).At the corresponding time point,there was no significant difference in VAS score,ROM,and AOFAS score between the two groups(P>0.05).Regarding to radiographic evaluation,there were no significant differences in the quality of fracture reduction and fracture healing time between the two groups in imaging studies(P>0.05).[Conclusion]Both medial and lateral minimal invasive plates combined with cannulated screw fixation do effectively treat tibial spiral fractures with Haraguchi type I posterior malleolus fractures.By contrast,the medial plate has benefit of less surgical trauma.
作者
王传鑫
孟德弘
张君
李壮
李景银
马亮
WANG Chuan-xin;MENG De-hong;ZHANG Jun;LI Zhuang;LI Jing-yin;MA Liang(Affiliated Hospital,Shandong University of Traditional Chinese Medicine;Shandong University of Traditional Chinese Medicine;Shandong Provincial Pharmacy Academy,Jinan 250012,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第19期1753-1758,共6页
Orthopedic Journal of China
基金
中国博士后科学基金第68批面上资助二等项目(编号:2020M682220)
中国博士后科学基金第14批特别资助项目(编号:2021T140423)。
关键词
胫骨螺旋骨折
HaraguchiⅠ型后踝骨折
微创经皮钢板接骨术
空心螺钉
tibial spiral fracture
Haraguchi type I posterior malleolus fracture
minimally invasive percutaneous plate osteosynthesis
cannulated screw
