Endobutton钢板与皮质骨螺钉治疗伴踝关节骨折的急性下胫腓联合损伤的比较

发布时间：2018-05-08 13:24

本文选题：Endobutton钢板 + 皮质骨螺钉　；参考：《安徽医药》2017年07期

【摘要】：目的比较两种内固定方法治疗伴踝关节骨折的急性下胫腓联合损伤疗效。方法回顾性分析66例伴踝关节骨折的急性下胫腓联合损伤的病例。其中31例接受Endobutton钢板治疗,35例接受皮质骨螺钉治疗。首先将两种疗法与术前指标作为自变量,治疗结果作为因变量作Logistic回归分析,再分别对两组术中出血量、手术时间、术后负重时间、术后1年下胫腓联合间隙(TBCS)、术后1年胫腓重叠影(TBOL)、AOFAS评分及并发症行统计学分析。结果性别为影响治疗结果的独立危险因素,而不同治疗方法与结果并无明显相关性。两组资料术中出血量(t=0.543,P=0.589)、术后1年TBCS(t=0.025,P=0.980)、术后1年TBOL(t=0.711,P=0.480)、AOFAS评分(t=0.577,P=0.566)及术后并发症(χ2=0.020,P=0.888)差异无统计学意义。手术时间(t=2.203,P=0.031)Endobutton钢板组较长,但术后负重时间(t=-18.459,P0.001)Endobutton钢板组较短,且均差异有统计学意义。结论 Endobutton钢板与皮质骨螺钉治疗伴踝关节骨折的急性下胫腓联合损伤疗效上无明显统计学差异,基本不需二次手术取出,术前应综合考虑,慎重选择内固定。
[Abstract]:Objective to compare the efficacy of two internal fixation methods in the treatment of acute lower tibiofibular joint injury with ankle fracture. Methods 66 cases of acute injury of inferior tibiofibular syndesmosis with ankle fracture were retrospectively analyzed. Among them, 31 cases were treated with Endobutton plate and 35 cases received cortical screw therapy. First, the two kinds of therapy and preoperative indexes were taken as independent variables, and the results of treatment were used as dependent variables for Logistic regression analysis. Then, the amount of intraoperative bleeding, the time of operation and the time of weight bearing after operation were analyzed respectively in the two groups. One year after operation, the tibiofibular syndesmosis space (TBCSA) and the tibiofibular overlap imaging (TBOL) AOFAS score and complications were analyzed statistically. Results gender was an independent risk factor for the outcome of treatment, but there was no significant correlation between different treatment methods and outcome. There was no significant difference between the two groups in terms of blood loss during operation (0.543), TBCST (0.025) and AOFAS score (0.577 / 0.566) and postoperative complications (蠂 ~ (20.020) P ~ (0.888). The operative time was longer in the group of 2. 203 and 0. 031 times of end button, but the time of loading after operation was shorter than that in the group of P 0. 001 and P 0. 001, and there were significant differences between the two groups (P < 0. 05, P < 0. 05). Conclusion there is no significant difference between Endobutton plate and cortical bone screw in the treatment of acute lower tibiofibular joint injury with ankle fracture.
【作者单位】：安徽医科大学附属六安医院骨科;
【分类号】：R687.3

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