摘要
目的探讨螺钉结合弹性垫片固定治疗下胫腓联合分离的疗效。方法将40例下胫腓联合分离患者按照随机数字表法分为对照组(采用皮质骨螺钉刚性固定,20例)和观察组(采用皮质骨螺钉结合弹性垫片固定,20例)。比较两组手术时间、术中出血量、住院时间、开始完全负重时间、踝关节活动度。采用疼痛VAS评分、AOFAS踝-后足评分评价临床疗效。结果患者均获得随访,时间6个月~2年。手术时间、术中出血量、住院时间两组比较差异均无统计学意义(P>0.05);开始完全负重时间观察组明显短于对照组(P<0.05)。疼痛VAS评分、AOFAS踝-后足评分两组术后各时间点均明显优于术前(P<0.05);术后3个月观察组均明显优于对照组(P<0.05)。末次随访时,采用AOFAS踝-后足评分标准评价的治疗优良率以及踝关节活动度两组比较差异均无统计学意义(P>0.05)。结论采用螺钉结合弹性垫片固定治疗下胫腓联合分离临床疗效较好,更利于患者早期完全负重,同时能有效减轻患者术后疼痛,促进踝关节功能的早期恢复。
Objective To explore the curative effect of screw combined with elastic gasket fixation in the treatment of distal tibiofibular syndesmosis disruption.Methods The 40 patients with distal tibiofibular syndesmosis disruption were randomly divided into control group(20 cases were adopted with cortical screw rigid fixation)and observation group(20 cases were performed with cortical screw combined with elastic gasket fixation),according to the random number method.The operation time,intraoperative blood loss,hospitalization time,time to start full weight-bearing and ankle joint activity were compared between the two groups.Pain VAS and AOFAS ankle-hindfoot score were used to evaluate the clinical efficacy.Results All patients were followed up from 6 months to 2 years.There were no statistical differences in operation time,intraoperative blood loss and hospitalization time between the two groups(P>0.05).The time of starting full weight-bearing in observation group was significantly shorter than that in control group(P<0.05).Pain VAS and AOFAS ankle-hindfoot score were significantly better than those before operation at various time-point after operation(P<0.05),and the observation group was obviously superior to the control at 3 months postoperation(P<0.05).At the last follow-up,two groups had no statistical differences in the excellent-good rate of treatment assessed with AOFAS ankle-hindfoot score criterion,and ankle joint activity(P>0.05).Conclusions The treatment of distal tibiofibular syndesmosis disruption with screws and elastic gaskets has a good clinical effect,which is more conducive to early full weight-bearing,and can effectively relieve postoperative pain and promote early recovery of ankle joint function.
作者
陈雷
李生旺
刘凯恒
张慧森
冯巍
高洋洋
李丹丹
CHEN Lei;LI Sheng-wang;LIU Kai-heng;ZHANG Hui-sen;FENG Wei;GAO Yang-yang;LI Dan-dan(Dept of Orthopaedics,the First Hospital of TCM of Baoding City,Baoding,Hebei 071000,China)
出处
《临床骨科杂志》
2022年第3期434-439,共6页
Journal of Clinical Orthopaedics
关键词
弹性垫片固定
下胫腓联合分离
踝关节
AOFAS踝-后足评分
elastic gasket fixation
lower tibiofibular syndesmosis disruption
ankle joint
AOFAS ankle-hindfoot score
