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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

所属专题: 文献

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/OL]. 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/OL]. 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)
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