双带绊纽扣钢板和金属螺钉治疗下胫腓联合损伤的疗效比较

发布时间：2018-11-15 20:21

【摘要】：目的比较双带绊纽扣钢板和金属螺钉固定治疗下胫腓骨联合损伤的临床疗效。方法将45例踝部骨折伴下胫腓联合损伤患者按入院日期奇偶数分成两组:A组(25例)采用双带绊纽扣钢板固定治疗,B组(20例)采用金属螺钉固定治疗(10~12周取出金属螺钉)。术后6个月对两组踝关节AOFAS功能评分、踝关节活动度进行临床评估,测量胫骨远端后外侧缘与腓骨远端内侧缘之间的距离(TFCS)和胫骨前结节外侧缘与腓骨内侧缘之间水平距离(TFO),进行影像学评价。结果患者均获得随访,时间6~15个月。术后6个月两组的踝关节AOFAS功能评分、踝关节活动度、TFCS和TFO比较差异均无统计学意义(P0.05)。结论双带绊纽扣钢板治疗下胫腓联合损伤可达到与金属螺钉固定相同的效果,并且能保留生理性微动,有利于早期负重活动,降低了内固定物松动或断裂的发生率,更利于关节功能康复。
[Abstract]:Objective to compare the clinical effect of double-band trip button plate and metal screw fixation in the treatment of combined injury of lower tibia and fibula. Methods Forty-five patients with ankle fracture associated with injury of lower tibiofibular syndesmosis were divided into two groups: group A (25 cases) were treated with double-band trip-button plate fixation. Group B (20 cases) were treated with metal screw fixation (10 ~ 12 weeks). At 6 months after operation, the AOFAS score and the range of motion of ankle joint in both groups were evaluated. The distance between the posterolateral margin of the distal tibia and the medial margin of the fibula and the horizontal distance between the lateral margin of the anterior tubercle of the tibia and the medial margin of the fibula were measured by (TFCS) for imaging evaluation. Results all patients were followed up for 6 ~ 15 months. Six months after operation, there was no significant difference in ankle AOFAS function score, ankle motion, TFCS and TFO between the two groups (P0.05). Conclusion Dual-band trip-button plate can treat the injury of the tibiofibular syndesmosis with the same effect as the metal screw fixation, and it can preserve the physiological fretting, which is beneficial to the early weight-bearing activity and reduces the incidence of looseness or fracture of the internal fixator. More conducive to the rehabilitation of joint function.
【作者单位】：桐乡市中医医院骨科;广州中医药大学附属骨伤科医院创伤骨科;
【分类号】：R687.32

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