钢板与螺钉内固定治疗大块后踝骨折的疗效比较

发布时间：2018-04-30 11:31

本文选题：后踝 + 骨折　；参考：《山西医科大学》2015年硕士论文

【摘要】：目的:比较钢板固定与单纯空心拉力螺钉内固定在治疗大块后踝骨折时的疗效,为临床工作提供参考。方法:选取自山西医科大学第二医院自2012年4月至2014年12月间,采用手术治疗涉及踝关节面大于25%的后踝骨折患者54例。其中29例采用钢板固定(钢板组),其中男性14例,女性15例,年龄18-69岁,平均年龄40.25岁。据Lauge-Hansen分型标准:旋后外旋III度9例,IV度13例;旋前外旋IV度7例。25例采用空心螺钉固定(螺钉组),其中男性14例,女性11例,年龄19-66岁,平均年龄40.44岁。据Lauge-Hansen分型标准:旋后外旋III度9例,IV度11例;旋前外旋IV度5例。术后定期随访并根据美国足踝外科协会(AOFAS)的踝-后足评分标准评价踝关节功能。记录两种治疗方法患者关节功能(术后1年AOFAS评分)、骨折愈合时间、完全负重时间及相关并发症等差异。结果:1例患者(钢板组)失随访,其余53例患者均获随访,随访时间10~16个月,平均13.7个月。两组患者骨折愈合时间、完全负重时间比较差异无统计学意义(P0.05),但末次随访AOFAS评分比较差异有统计学意义(P0.05)。结论:对于骨折块累及踝关节面大于25%的后踝骨折,钢板及螺钉均为有效治疗方法。但相比于单纯空心拉力螺钉固定,钢板可以使踝关节功能在早期得到最大限度恢复,提高手术治疗效果。
[Abstract]:Objective: to compare the effect of plate fixation and hollow screw fixation in the treatment of large posterior ankle fracture. Methods: from April 2012 to December 2014, 54 patients with posterior malleolus fracture involving more than 25% of the ankle surface were treated with surgical treatment from the second Hospital of Shanxi Medical University. Among them, 29 cases were fixed with steel plate (steel plate group, 14 males and 15 females, aged 18-69 years, mean age 40.25 years). According to Lauge-Hansen classification criteria, 9 cases of III degree and 7 cases of IV degree were treated with hollow screw fixation (screw group, 14 males and 11 females, age 19-66 years, mean age 40.44 years). According to Lauge-Hansen classification criteria, 9 cases had III degree of circumflex and 11 cases had grade IV, 5 cases had degree IV of pronation. The ankle function was evaluated according to the ankle-hind foot score of the American Association of foot and ankle Surgeons. The differences of joint function (AOFAS score, fracture healing time, total weight loading time and related complications) between the two treatments were recorded. Results one patient (steel plate group) was followed up, the other 53 cases were followed up for 10 ~ 16 months (mean 13.7 months). There was no significant difference in fracture healing time and total weight bearing time between the two groups (P 0.05), but there was significant difference in AOFAS score at the last follow-up (P 0.05). Conclusion: plate and screw are effective for the fracture of the posterior malleolus fracture in which the ankle joint is more than 25%. But compared with hollow screw fixation, plate can make ankle function recover as early as possible and improve the effect of surgical treatment.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

【参考文献】