摘要
目的 探讨不同内固定方式治疗老年踝关节骨折(AF)的临床疗效。方法 纳入该院2019年1月—2020年6月收治的102例老年AF患者,采用随机数字表法分为两组,各51例。对照组采用切开复位内固定治疗,观察组采用闭合复位经皮空心螺钉内固定治疗,随访至术后6个月。对两组手术效果、手术指标、疼痛程度、肿胀程度、踝关节功能及并发症发生率进行比较。结果 观察组手术治疗优良率94.12%高于对照组的76.47%,术中出血量(14.34±3.05)mL少于对照组的(37.26±4.81)mL,手术时间(42.39±2.77)min、骨折愈合时间(9.06±0.68)周均短于对照组的(61.24±4.32)min、(13.21±1.51)周,术后7 d的视觉模拟评分法评分(2.08±0.44)分及肿胀值(5.51±1.20)cm均低于对照组的(3.75±0.56)分、(9.23±1.75)cm,术后6个月美国矫形外科足踝协会评分(82.36±7.24)分高于对照组的(71.42±6.03)分,并发症发生率3.92%低于对照组的17.65%,组间差异有统计学意义(P<0.05)。结论 在老年AF患者中采用闭合复位经皮空心螺钉内固定治疗的效果较佳,可减轻肿痛,加速骨折愈合,改善踝关节功能,且安全性高,利于预后。
Objective To investigate the clinical efficacy of different internal fixation methods in the treatment of elderly ankle fractures(AF).Methods A total of 102 elderly patients with AF admitted to the hospital from January 2019 to June 2020 were included and divided into two groups by random number table method,with 51 cases in each group.The control group was treated with open reduction and internal fixation,while the observation group was treated with closed reduction and percutaneous cannulated screw internal fixation.The patients were followed up for 6 months after operation.The surgical effect,surgical index,pain degree,swelling degree,ankle joint function and complication rate were compared between the two groups.Results The excellent and good rate of surgical treatment in the observation group was 94.12%,which was higher than 76.47%in the control group,the intraoperative blood loss(14.34±3.05)mL was less than(37.26±4.81)mL of the control group,the operation time(42.39±2.77)min and fracture healing time(9.06±0.68)weeks were shorter than(61.24±4.32)min and(13.21±1.51)weeks of the control group,the visual analogue scale score(2.08±0.44)points and the swelling value(5.51±1.20)cm at 7 days after operation were lower than(3.75±0.56)points and(9.23±1.75)cm of the control group,the American Orthopaedic Foot and AnHe Society score at 6 months after surgery(82.36±7.24)points was higher than(71.42±6.03)points of the control group,the complication rate of 3.92%was lower than 17.65%of the control group,and the differences between the groups were statistically significant(P<0.05).Conclusion In elderly patients with AF,closed reduction and percutaneous cannulated screw internal fixation has a better effect,which can reduce swelling and pain,accelerate fracture healing,and improve ankle joint function,with high safety and good prognosis.
作者
汤四昌
夏智昌
TANG Sichang;XIA Zhichang(The Second Department of Orthopedics,Urumqi Friendship Hospital,Urumqi Xinjiang,830049,China)
出处
《反射疗法与康复医学》
2021年第10期54-56,83,共4页
Reflexology And Rehabilitation Medicine
关键词
踝关节骨折
老年
切开复位内固定
闭合复位经皮空心螺钉内固定
疗效
疼痛
Ankle fracture
Elderly
Open reduction and internal fixation
Closed reduction and percutaneous hollow screw internal fixation
Curative effect
Pain
