摘要
目的分析切开复位内固定术(open reduction and internal fixation,ORIF)治疗踝关节骨折的疗效及术后踝关节功能恢复的影响因素。方法回顾性收集本院采取ORIF治疗的105例踝关节骨折患者的临床资料。依据美国足踝外科协会踝-后足评分系统评估患者手术前后踝关节功能的恢复情况,统计术后并发症的发生情况,采用单因素和多因素Logistic回归分析患者术后踝关节功能恢复的影响因素。结果105例患者中,术后踝-后足评分优40例、良34例、可18例、差13例,优良率为70.48%。患者术后12个月踝-后足评分高于术前,差异有统计学意义(P<0.05)。105例患者术后发生下肢深静脉血栓1例、腓骨肌腱疼痛1例、切口感染2例、伤口愈合延迟4例,均通过对症处理后好转;术后12个月,患者出现局部皮肤麻木9例,创伤性关节炎13例。以踝-后足评分优、良为A组(74例),踝-后足评分可、差为B组(31例),经单因素分析发现两组年龄、受伤至手术时间、是否取出内固定物、是否坚持行功能锻炼、术后是否出现并发症比较,差异有统计学意义(P<0.05);两组性别、AO分型、骨折原因、糖尿病、高血压、是否为开放损伤、是否跟骨牵引比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,术后并发症是踝关节骨折患者术后踝关节功能恢复的危险因素(P<0.05),坚持行功能锻炼是患者术后踝关节功能恢复的保护因素(P<0.05)。结论经ORIF治疗可有效改善踝关节骨折术后踝关节功能,并且术后并发症的发生可能会减缓患者踝关节功能的恢复,而术后坚持行功能锻炼可促进踝关节功能的恢复,因此术后应积极防治相关并发症的发生,并加强功能锻炼以促进踝关节功能的恢复。
Objective To analyze the effect of open reduction and internal fixation(ORIF)in the treatment of ankle fracture and the influencing factors of ankle function recovery.Methods A retrospective study was conducted to collect the clinical data of 105 patients with ankle fracture,all of whom were treated with ORIF.According to the ankle posterior foot scoring system of American Association of foot and ankle surgery,the recovery of ankle joint function before and after operation was evaluated,and the incidence of postoperative complications was counted.The influencing factors of ankle joint function recovery were analyzed by single factor and multi factor Logistic regression.Results Among the 105 patients,there were 40 excellent,34 good,18 fair and 13 poor in ankle posterior foot score,and the excellent rate was 70.48%.The ankle hind foot score was significantly higher than that before operation(P<0.05).Among 105 patients,postoperative complications included deep vein thrombosis(1 case),peroneal tendon pain(1 case),incision infection(2 cases)and delayed wound healing(4 cases),all of which improved after symptomatic treatment;12 months after operation,local skin numbness occurred in 9 cases and traumatic arthritis in 13 cases.Then the excellent and good ankle posterior foot scores were classified into group A(74 cases)and the poor ankle posterior foot scores into group B(31 cases).The univariate analysis results showed that there were significant differences between the two groups in age,time from injury to operation,removal of internal fixation,functional exercise and complications(P<0.05)There was no significant difference in hypertension,open injury and traction of calcaneus(P>0.05).Logistic regression analysis showed that postoperative complications were the risk factors of ankle function recovery in patients with ankle fracture(P<0.05),and functional exercise was the protective factor of ankle function recovery(P<0.05).Conclusion ORIF treatment can effectively improve the ankle function after ankle fracture surgery,and the occurrence of postoperative complications may slow down the recovery of ankle function of patients,and functional exercise can promote the recovery of ankle function after surgery,so we should actively prevent and treat the occurrence of related complications,and strengthen functional exercise to promote the recovery of ankle function.
作者
尹金旺
朱康
王晓桐
丁宝江
杜海山
Yin Jinwang;Zhu Kang;Wang Xiaotong;Ding Baojiang;Du Haishan(Department of Orthopedics and Traumatology,Changping District Hospital of Traditional Chinese Medicine,Beijing 102200,China)
出处
《足踝外科电子杂志》
2020年第2期15-18,共4页
Electronic Journal of Foot and Ankle Surgery
基金
北京市科技计划课题(编号:1311000497)。
关键词
切开复位内固定术
踝关节骨折
踝关节功能
open reduction and internal fixation
ankle fracture
ankle function
