| 陈长青,王成,王耀生,等.钢板与空心钉治疗Haraguchi Ⅰ型后踝骨折的疗效比较.骨科,2016,7(5): 333-337. |
| 钢板与空心钉治疗Haraguchi Ⅰ型后踝骨折的疗效比较 |
| The comparison of two surgical methods for Haraguchi type Ⅰ posterior malleolus fractures |
| 投稿时间：2016-02-03 |
| DOI：10.3969/j.issn.1674-8573.2016.05.009 |
| 中文关键词: 踝关节 骨折 骨折固定术，内 治疗结果 |
| 英文关键词: Ankle joint Fractures Fracture fixation, internal Treatment outcome |
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| 中文摘要: |
| 目的 比较钢板与空心钉治疗Haraguchi Ⅰ型后踝骨折的疗效，为临床治疗提供参考依据。方法 回顾性分析2012年6月至2014年10月于我院采用切开复位内固定（钢板或空心钉）治疗Haraguchi Ⅰ型后踝骨折40例患者的资料，使用钢板内固定的24例患者纳入钢板组，使用空心钉固定的16例患者纳入空心钉组，比较两组患者的骨折愈合时间及其术后3、12、18个月的美国足踝外科医师协会（AOFAS）踝与后足功能评分。结果 34例患者获得随访（钢板组20例，空心钉组14例）。钢板组与空心钉组的平均骨折愈合时间分别为（9.4±2.5）个月和（12.5±2.9）个月，差异有统计学意义（t=-3.604，P=0.001）。术后3个月，空心钉组有2例患者出现后踝骨折块移位。术后3个月时，钢板组的AOFAS评分为（70.6±7.1）分，低于空心钉组的（76.9±6.2）分，差异有统计学意义（t=-2.888，P=0.036）；术后12、18个月时，钢板组的AOFAS评分分别为（85.1±8.5）分、（93.7±9.8）分，均优于空心钉组的（79.5±6.9）分、（83.5±7.3）分，差异均有统计学意义（t=2.194，P=0.044；t=3.552，P=0.001）。结论 采用钢板内固定治疗合并后踝骨折的踝关节损伤，较空心钉内固定具有固定牢靠、后期功能恢复较好等优点，值得推广。 |
| 英文摘要: |
| Objective To compare the efficacy of plate and hollow screw in the treatment of Haraguchi type Ⅰ posterior malleolus fractures. Methods From June 2012 to October 2014, we retrospectively analyzed 40 patients with Haraguchi type Ⅰ posterior malleolar fractures which were treated by open reduction and internal fixation (plate or cannulated screw) in our hospital. According to the fixed methods, patients were divided into plate group (24 cases) and cannulated screw group (16 cases). The fracture healing time and American Orthopaedic Foot and Ankle Society (AOFAS) ankle and foot function score at 3rd, 12th and 18th month postoperation were compared between two groups. Results Thirty-four cases were followed up (20 cases in the plate group, and 14 cases in the cannulated screw group). The average healing time of plate group and cannulated screw group was (9.4±2.5) months and (12.5±2.9) months respectively with the difference being statistically significant (t=-3.604, P=0.001). At 3rd month after operation, 2 patients in cannulated screw group had posterior ankle fragment shift. After 3 months, the AOFAS scores in the plate group were 70.6±7.1, less than those in the cannulated screw group (76.9±6.2), and the difference was statistically significant (t=-2.888, P=0.036); At 12th and 18th month postoperation, AOFAS scores in the plate group were 85.1±8.5 and 93.7±9.8 respectively, which higher than those in the cannulated screw group (79.5±6.9, and 83.5±7.3 respectively), and the differences were statistically significant (t=2.194, P=0.044; t=3.552, P=0.001). Conclusion As compared with the cannulated screw, the internal fixation with plate fixation in the treatment of ankle fracture of the ankle joint injury is more satisfactory with a fixed solid and better functional recovery, and it is worth promoting. |
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