[1]石 丹,张会久,周达岸.闭合复位经皮空心螺钉内固定与切开复位内固定治疗踝关节骨折疗效对比研究[J].陕西医学杂志,2019,(2):186-188,216.
 SHI Dan,ZHANG Huijiu,ZHOU Daan..Comparison of closed reduction, percutaneous cannulated screw fixation and open reduction  and internal fixation for ankle fractures[J].,2019,(2):186-188,216.
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闭合复位经皮空心螺钉内固定与切开复位内固定治疗踝关节骨折疗效对比研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年2期
页码:
186-188,216
栏目:
临床研究
出版日期:
2020-02-05

文章信息/Info

Title:
Comparison of closed reduction, percutaneous cannulated screw fixation and open reduction  and internal fixation for ankle fractures
文章编号:
DOI: 10.3969/j.issn.10007377.2019.02.013
作者:
石 丹1张会久2周达岸1
1.锦州医科大学附属第三医院康复科(锦州121000);2.锦州医科大学附属第三医院骨外科(锦州 121000)
Author(s):
SHI Dan ZHANG Huijiu ZHOU Da’an.
Department of Rehabilitation, the Third Affiliated Hospital of Jinzhou Medical University(Jinzhou 121000)
关键词:
踝关节骨折治疗骨折固定术闭合复位经皮空心螺钉内固定切开复位内固定
Keywords:
Key words Ankle fractureTherapyFracture fixationClosed reductionPercutaneous cannulated screw fixation Open reduction and internal fixation
分类号:
R683.4
文献标志码:
A
摘要:
摘 要 目的:对比分析闭合复位经皮空心螺钉内固定与切开复位内固定治疗踝关节骨折的效果。方法:踝关节骨折患者129例,按照手术方法不同分为闭合复位组68例与切开复位组61例。闭合复位组采用闭合复位经皮空心螺钉内固定治疗,切开复位组采用切开复位内固定治疗。比较两组疗效,术前和术后1个月、3个月、6个月踝关节功能改善情况,及术中和术后情况。结果:闭合复位组总有效率(95.59%)高于切开复位组(80.33%),且有统计学差异(P<0.05)。两组术后1个月、3个月和6个月踝关节功能评分高于术前,且有统计学差异(P<0.05);闭合复位组术后1个月、3个月和6个月踝关节功能评分高于同期切开复位组,且有统计学差异(P<0.05)。闭合复位组术中出血量少于切开复位组,手术时间短于切开复位组,骨折愈合时间快于切开复位组,均有统计学差异(P<0.05)。闭合复位组术后并发症发生率(1.47%)低于切开复位组(19.67%),且有统计学差异(P<0.05)。结论:闭合复位经皮空心螺钉内固定术治疗踝关节骨折患者效果优于切开复位内固定术。
Abstract:
Abstract Objective: To compare and analyze the effect of closed reduction and percutaneous cannulated screw fixation and open reduction and internal fixation in the treatment of ankle fractures. Methods: 129 cases of ankle fractures were selected .They were divided into closed reduction group (68 cases) and open reduction group (61 cases) according to different surgical methods. The closed reduction group was treated with closed reduction and percutaneous cannulated screw fixation, and the open reduction group was treated with open reduction and internal fixation. The improvement of ankle function, intraoperative and postoperative conditions were compared between the two groups before and after 1 months, 3 months and 6 months. Results: The total effective rate of closed reduction group (95.59%) was higher than that of open reduction group (80.33%) (P<0.05). A score of 1 months, 3 months and 6 months of ankle joint function after operation in two groups were higher than those before (P<0.05); closed reduction group after 1 months, 3 months and 6 months, the ankle score higher than the same period of open reduction group (P<0.05). The amount of bleeding in the closed reduction group was less than that in the open reduction group, and the operation time was shorter than that of the incision reduction group, and the healing time of the fracture was faster than that in the incision reduction group (P<0.05). The incidence of postoperative complications in the closed reduction group (1.47%) was lower than that in the incision reduction group (19.67%) (P<0.05). Conclusion:Closed reduction and percutaneous cannulated screw fixation is better than open reduction and internal fixation in the treatment of ankle fracture.

参考文献/References:

\[1\] Furman BD, Kimmerling KA, Zura RD, et al. Articular ankle fracture results in increased synovitis, synovial macrophage infiltration, and synovial fluid concentrations of inflammatory cytokines and chemokines\[J\]. Arthritis & Rheumatology, 2015, 67(5):1234.
\[2\] Ackermann J, Fraser EJ, Murawski CD, et al. Trends of concurrent ankle arthroscopy at the time of operative treatment of ankle fracture: a national database review\[J\]. Foot Ankle Spec, 2016, 9(2):107112.
\[3\] Elbaz A, Mor A, Segal G, et al. Lower Extremity kinematic profile of gait of patients after ankle fracture: a casecontrol study\[J\]. Journal of Foot & Ankle Surgery, 2016, 55(5):918921.
\[4\] Gonzalez TA, Macaulay AA, Ehrlichman LK, et al. Arthroscopically assisted versus standard open reduction and internal fixation techniques for the acute ankle fracture\[J\]. Foot & Ankle International, 2016, 37(5):554.
\[5\] 陈京峰, 仝晓明, 李治斌. 补阳还五汤加减配合切开复位内固定术治疗旋后外旋型踝关节骨折的疗效观察\[J\]. 中华中医药学刊, 2016(4):10211024.
\[6\] 何玲玲,白正发,何大鹏.踝关节骨折44例手术治疗体会\[J\].陕西医学杂志,2011,40(5):601602.
\[7\] Warner SJ, Schottel PC, Hinds RM, et al. Fracturedislocations demonstrate poorer postoperative functional outcomes among pronation external rotation IV ankle fractures\[J\]. Foot & Ankle International, 2015, 36(6):641647.
\[8\] Kim JH, Gwak HC, Lee CR, et al. A comparison of screw fixation and suturebutton fixation in a syndesmosis injury in an ankle fracture\[J\]. Journal of Foot & Ankle Surgery, 2016, 55(5):985990.
\[9\] Matuszewski PE, Dombroski D, Lawrence JT, et al. Prospective intraoperative syndesmotic evaluation during ankle fracture fixation: stress external rotation versus lateral fibular stress\[J\]. Journal of Orthopaedic Trauma,2015,29(4):15760.〖ZK)〗
\[10\] Neilly D, Baliga S, Munro C, et al. Acute compartment syndrome of the foot following Open Reduction and Internal fixation of an Ankle fracture\[J\]. Injuryinternational Journal of the Care of the Injured, 2015, 46(10):20642068.〖ZK)〗
\[11\] Futamura K, Baba T, Mogami A, et al. Malreduction of syndesmosis injury associated with malleolar ankle fracture can be avoided using Weber's three indexes in the mortise view\[J\]. Injuryinternational Journal of the Care of the Injured, 2017, 48(4):954959.
\[12\] Visser HJ, Malik K, Djali RA. FibularLengthening osteotomy to correct a malunited ankle fracture using freshfrozen femoral head allograft\[J\]. Journal of the American Podiatric Medical Association, 2017, 107(4):318.
\[13\] 陈仁春, 毛兴敏, 缪标烈. 踝关节骨折行切开复位内固定治疗的临床有效性初评\[J\].中国伤残医学,2017, 25(7):4749.
\[14\] 刘照富, 殷铁林, 孙玉娟. 切开复位内固定与石膏固定治疗不稳定型踝关节骨折临床比较\[J\]. 医药论坛杂志, 2016, 14(5):7980.
\[15\] 魏志祥, 程 毅, 沈洪弟. 切开复位内固定治疗踝关节骨折的临床分析\[J\].中国伤残医学,2016, 24(17):4748.
\[16\] 安晓龙,党海峰.外踝后侧入路治疗踝关节旋后外旋型骨折的临床应用\[J\].陕西医学杂志,2014,43(9):11971198.
\[17\] 叶圣昭, 冯永增. 经皮微创闭合复位与切开复位内固定治疗踝关节骨折的临床疗效比较研究\[J\]. 浙江创伤外科, 2015, 20(5):971973.
\[18\] 周利强, 晏 葵, 陈 娟, 等. 两种经皮螺钉内固定微创手术治疗踝关节骨折的疗效对比\[J\]. 湖南师范大学学报:医学版,2017, 14(2):5759.
\[19\] 陈雪冲, 刘小勇, 王国华, 等. 闭合复位经皮空心钉及钢板内固定治疗踝关节骨折的疗效分析\[J\]. 创伤外科杂志, 2016, 18(4):233235.
\[20\] 相小刚. 闭合复位经皮空心螺钉内固定与传统切开复位治疗踝关节骨折效果观察\[J\]. 河南外科学杂志, 2017, 23(1):114115.

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更新日期/Last Update: 2019-03-13