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中华关节外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (06) : 684 -687. doi: 10.3877/cma.j.issn.1674-134X.2019.06.006

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临床论著

踝关节旋后外旋、旋前外旋Ⅳ型骨折三角韧带修复效果比较
武京伟1, 刘利民1,(), 胡怀建1, 高志华1   
  1. 1. 100053 北京,首都医科大学宣武医院骨科
  • 收稿日期:2018-03-26 出版日期:2019-12-01
  • 通信作者: 刘利民

Effects of deltoid ligament repair for type IV fracture of supination-external and pronation-external rotation of ankle joint

Jingwei Wu1, Limin Liu1,(), Huaijian Hu1, Zhihua Gao1   

  1. 1. Department of Orthopedics, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
  • Received:2018-03-26 Published:2019-12-01
  • Corresponding author: Limin Liu
  • About author:
    Corresponding author: Liu Limin, Email:
引用本文:

武京伟, 刘利民, 胡怀建, 高志华. 踝关节旋后外旋、旋前外旋Ⅳ型骨折三角韧带修复效果比较[J]. 中华关节外科杂志(电子版), 2019, 13(06): 684-687.

Jingwei Wu, Limin Liu, Huaijian Hu, Zhihua Gao. Effects of deltoid ligament repair for type IV fracture of supination-external and pronation-external rotation of ankle joint[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2019, 13(06): 684-687.

目的

比较旋后外旋(SER)Ⅳ型、旋前外旋(PER)Ⅳ型踝关节骨折三角韧带断裂修复治疗的治疗效果。

方法

回顾性分析首都医科大学宣武医院骨科于2016年1月至2018年1月收治的SER、PER Ⅳ型踝关节骨折患者。纳入标准:三角韧带断裂;随访超过1年。排除标准:年龄≥70岁、踝关节存在陈旧性损伤、内踝骨折、同侧下肢其他部位骨折、开放性骨折、无法配合功能锻炼、病理性骨折。按照纳入排除标准,共有68例纳入本研究,SER组47人,PER组21人。评估两组患者术后1年后的踝关节美国足踝外科协会(AOFAS)评分、生活质量(QOL)评分,采用t检验比较两组之间的差异。

结果

SER组患者的踝关节功能恢复情况优于PER组(t=8.314,P<0.05);SER组的躯体健康优于PER组患者(t=0.766,P<0.05)、但精神健康方面两组患者基本一致(t=0.452,P>0.05),合计SF-36的总分后,发现两组患者的QOL无明显差异(t=0.172,P>0.05)。

结论

踝三角韧带断裂行修复后,SER Ⅳ型骨折患者的踝关节功能恢复情况、躯体QOL比PER Ⅳ型患者好,但是两组患者的精神健康QOL、总体QOL基本一致。

Objective

To compare the effect of repair of deltoid ligament rupture with posterior external rotation (SER) IV and pronation external rotation (PER) IV fractures of ankle joint.

Methods

A total of 68 patients in the hospital from January 2016 to January 2018 who met the inclusion criteria (SER IV or PER IV ankle fractures, deltoid ligament rupture, followed up for more than one year) and exclusion criteria (age≥70 years, old ankle injury, medial ankle fractures, fractures of other parts of ipsilateral lower limb, open fractures, unable to cooperate with functional exercise, pathological fracture) were divided into SER group (47 patients) and PER group (21 patients). The Armerican Orthopedic Foot & Ankle Society (AOFAS) score and quality of life (QOL) score of the two groups were evaluated one year after surgery, and the difference between the two groups was compared using t-test.

Results

The ankle function recovery (t=8.314, P<0.05) and physical health (t=0.766, P<0.05) of the SER group were better than those of the PER group, but the mental health of the 2 groups were basically the same (t=0.452, P>0.05). After comparing the total score of SF-36, there was no significant difference in the QOL between the two groups (t=0.172, P>0.05).

Conclusions

After deltoid ligament repair, the ankle function recovery, physical component summary of patients with SER IV fractures are better than those of PER IV patients. However, the mental health QOL and overall QOL are basically the same.

表1 两组踝关节骨折患者的一般情况
表2 两组踝关节骨折患者的生活质量比较[分,(±s)]
图1 左踝关节旋后外旋Ⅳ型骨折,术中明显可见断裂的胫舟韧带断端(止血钳、镊子所指处)
[1]
Lauge-Hansen N. Fractures of the ankle. II. Combined experimental-surgical and experimental-roentgenologic investigations[J]. Arch Surg,1950,60(5):957-985.
[2]
Amaha K, Nimura A, Yamaguchi R, et al. Anatomic study of the medial side of the ankle base on the joint capsule: an alternative description of the deltoid and spring ligament[J]. J Exp Orthop,2019,6(1):2.
[3]
Panchani PN, Chappell TM, Moore GD, et al. Anatomic study of the deltoid ligament of the ankle[J]. Foot Ankle Int,2014,35(9):916-921.
[4]
王萌,程勇杰,李龙云. 踝关节骨折手术时机选择的临床研究[J/CD]. 中华关节外科杂志(电子版),2013,7(2):254-256.
[5]
Federici A, Sanguineti F, Santolini F. The closed treatment of severe malleolar fractures[J]. Acta Orthop Belg,1993,59(2):189-196.
[6]
Mccollum GA, van den Bekerom MPJ, Kerkhoffs GMMJ, et al. Syndesmosis and deltoid ligament injuries in the athlete[J]. Knee Surg Sports Traumatol Arthros,2013,21(6):1328-1337.
[7]
Beals TC, Crim J, Nickisch F. Deltoid ligament injuries in athletes: techniques of repair and reconstruction[J]. Oper Tech Sports Med,2010,18(1):11-17.
[8]
何河北,董伟强,孙永建,等. 修复三角韧带与不修复对于踝关节骨折合并三角韧带损伤术效果的meta分析[J/CD]. 中华关节外科杂志(电子版),2014(4):497-501.
[9]
Cho BK, Kim YM, Kim DS, et al. Outcomes of the modified brostrom procedure using suture anchors for chronic lateral ankle instability-a prospective, randomized comparison between single and double suture anchors[J]. J Foot Ankle Sur,2013,52(1):9-15.
[10]
Lack W, Phisitkul P, Femino JE. Anatomic deltoid ligament repair with anchor-to-post suture reinforcement: technique tip[J]. Iowa Orthop J,2012,32:227-230.
[11]
Vega J, Golano P, Pellegrino A, et al. All-inside arthroscopic lateral collateral ligament repair for ankle instability with a knotless suture anchor technique[J]. Foot Ankle Int,2013,34(12):1701-1709.
[12]
Khanna D, Tsevat J. Health-related quality of life-an introduction[J]. Am J Manag Care,2007,13 (9,s)9:S218-S223.
[13]
Mundi R, Bhandari M. Devastating impact of fracture nonunions: the need for timely identification and intervention for high-risk patients: commentary on an article by patrick c. Schottel, MD, et al.: " time trade-off as a measure of health-related quality of life: long bone nonunions have a devastating impact" [J/OL]. J Bone Joint Surg Am,2015,97(17):e62.doi:10.2016/JBJS.0.00722.
[14]
Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection[J]. Med Care,1992,30(6):473-483.
[15]
刘志伟,关岚,王梦琴,等. 2009年至2016年北京积水潭医院老年骨折患者的流行病学特点[J]. 中华急诊医学杂志,2017,26(8):860-864.
[16]
严文琪,王凯. 手法整复与手术治疗老年人踝关节旋后外旋ⅳ型骨折[J/CD]. 中华关节外科杂志(电子版),2018,12(6):25-27.
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