探讨经皮螺钉内固定微创手术治疗踝关节骨折的效果及其对患者生活质量评分(QOL)的影响。

根据纳入排除标准，选取120例2015年1月至2019年10月在云浮市人民医院治疗踝关节骨折的患者。纳入标准：确诊为新鲜闭合性踝关节骨折；临床资料完整；非Pilon或粉碎性骨折。排除标准：对本研究所涉术式存在禁忌证；下胫腓关节分离；压缩性、粉碎性骨折；心脑血管病变者，重要器官功能异常及恶性肿瘤；精神功能障碍。应用信封法分组为对照组(60例)和研究组(60例)两组，两组患者均实施手术治疗，对照组使用传统切开复位内固定术治疗，研究组使用经皮螺钉内固定微创手术进行治疗。对比两组患者生活质量(QOL)评分、两组临床指标状况、两组患者预后状况以及对比两组患者踝关节功能恢复状况。计量资料采用t检验，计数资料使用卡方检验。

研究组患者在社会功能(t＝16.332)、心理功能(t＝15.663)、情感智能(t＝17.452)、认知功能(t＝17.998)、躯体功能(t＝18.552)、总体健康(t＝17.552)、疼痛(t＝19.695)、生理功能(t＝20.998)方面的生活质量评分均比对照组高(均为P<0.05)；研究组患者手术操作耗时(t＝16.332)、骨折愈合时间(t＝17.928)、住院时间(t＝15.489)均比对照组短，且研究组患者术中出血量更少(t＝18.032)(均为P<0.05)；研究组手术切口感染、骨折不愈合、内固定外露、愈合后踝关节疼痛的总发生率为8.3%，对照组为28.3%，对比发现研究组的发生率更低(χ²＝7.002，P<0.05)；研究组患者踝关节功能术后的优良率比对照组更高(χ²＝7.009，P<0.05)。

经皮螺钉内固定微创手术治疗踝关节骨折，踝关节功能恢复良好，可提升患者QOL评分，促进骨折愈合，减少住院时间，提升预后效果，临床感染率低，有临床推广价值。

To investigate the effect of minimally invasive surgery with percutaneous screw internal fixation on patients with ankle fractures and the effect on the quality of life(QOL)scores.

From January 2015 to October 2019, 120 patients with ankle fractures who were admitted to Yufu People's Hospital for treatment during this time period were selected. The envelope method was used to divide the patients into the control group and the study group, 60 cases each. All the patients in the group were treated with surgery. The control group was treated with traditional incision and reduction and internal fixation. The study group was treated with minimally invasive surgery with percutaneous screw internal fixation. The quality of life(QOL)scores, the clinical status of the two groups, the prognosis of the two groups of patients, and the ankle function recovery of the two groups were compared. Chi-square test and t test were applied for data analysis.

The quality of life scores of patients in the study group were higher than those in the control group in terms of social function, psychological function, emotional intelligence, cognitive function, physical function, overall health, pain and physiological function (t=16.332, 15.663, 17.452, 17.998, 18.552, 17.552, 19.695 and 20.998 respectively, all P <0.05); the operation time, fracture healing time and hospitalization time of patients in the study group were all higher than those in the control group Compared with the control group, the patients in the study group had less intraoperative bleeding (t=16.332, 17.928, 15.489, 18.032, respectively, all P <0.05); the total incidence of ankle joint pain in the study group was 8.3% after surgical incision infection, nonunion of fracture, exposure of internal fixation, and healing, compared with 28.3% in the control group, the incidence in the study group was lower (χ²=7.002, P<0.05). The patients in the study group had ankle joint pain.The excellent and good rate of postoperative joint function was higher than that of the control group(χ²=7.009, P<0.05).

The use of percutaneous screw internal fixation for minimally invasive surgery in patients with ankle fractures can improve the ankle joint function, improve the QOL score of patients, promote fracture healing, reduce hospitalization time, and improve prognosis and clinical infection.