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中华老年骨科与康复电子杂志 ›› 2025, Vol. 11 ›› Issue (05) : 309 -314. doi: 10.3877/cma.j.issn.2096-0263.2025.05.007

骨与创伤

切开复位内固定术联合不同韧带修复方式治疗踝关节骨折合并下胫腓前韧带断裂的疗效
赵雪超, 佟向阳(), 刘大诚, 张强   
  1. 221000 徐州医科大学附属徐州市立医院骨科
  • 收稿日期:2024-03-12 出版日期:2025-10-05
  • 通信作者: 佟向阳
  • 基金资助:
    徐州医科大学科技园"创新创业项目"(CXCYYB2024014)

Efficacy of open reduction and internal fixation combined with different ligament repair methods in ankle fracture with anterior ligament rupture

Xuechao Zhao, Xiangyang Tong(), Dacheng Liu, Qiang Zhang   

  1. Department of Orthopaedics, Xuzhou Municipal Hospital affiliated to Xuzhou Medical University, Xu zhou 221000, China
  • Received:2024-03-12 Published:2025-10-05
  • Corresponding author: Xiangyang Tong
引用本文:

赵雪超, 佟向阳, 刘大诚, 张强. 切开复位内固定术联合不同韧带修复方式治疗踝关节骨折合并下胫腓前韧带断裂的疗效[J/OL]. 中华老年骨科与康复电子杂志, 2025, 11(05): 309-314.

Xuechao Zhao, Xiangyang Tong, Dacheng Liu, Qiang Zhang. Efficacy of open reduction and internal fixation combined with different ligament repair methods in ankle fracture with anterior ligament rupture[J/OL]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2025, 11(05): 309-314.

目的

分析切开复位固定术联合不同韧带修复方式治疗对踝关节骨折合并下胫腓前韧带断裂的疗效及预后情况,为该病患者的康复提供相关参考帮助。

方法

对我院2021年10月至2022年10月收治的踝关节骨折合并下胫腓前韧带断裂的57例患者临床资料进行分析,男33例、女24例。根据患者治疗方式分为A组(切开复位联合三角韧带修复,30例),男18例、女12例,年龄(45.2±6.8)岁。B组(切开复位联合下胫腓联合螺钉固定修复,27例),男15例、女12例,年龄(45.5±7.2)岁。观察两组患者临床手术疗效及预后康复情况。

结果

A组患者住院时间为(15.66±2.12)d,骨折愈合时间为(11.44±2.00)周,明显低于B组的(18.70±2.45)d、(13.56±2.01)周(t=5.022、3.986,均P<0.05)。VAS评分重复测量设计的方差分析显示,不同组别间差异有统计学意义,组别与时间点间存在交互作用,各时间点除术前外两组差别均有统计学意义;组内不同时间点差别有统计学意义,随着时间的延长,VAS评分逐渐降低(P<0.05)。Baird-Jackson评分进行重复测量设计的方差分析,不同组别间差异有统计学意义,术后6个月、术后3个月A组Baird-Jackson评分明显高于B组(P<0.05),组别与时间点间存在交互作用;随着时间的延长,Baird-Jackson评分逐渐提高(P<0.05)。术后6个月时A组优良率(93.33%)高于B组(62.96%)(P<0.05)。两组患者术后并发症发生率差异无统计学意义(P>0.05)。

结论

与下胫腓联合螺钉固定修复相比,三角韧带修复在住院时间、骨折愈合时间、疼痛缓解、踝关节功能恢复以及优良率方面均表现出明显优势。

Objective

To analyze the efficacy and prognosis of incision reduction and fixation combined with Different methods of ligament repair for ankle fracture combined with lower tibiofibular anterior ligament rupture, and to provide relevant references for the rehabilitation of patients with this disease.

Methods

The clinical data of 57 patients with ankle fracture combined with lower tibiofibular anterior ligament rupture from October 2021 to October 2022 in our hospital were analyzed. The patients were divided into group A (30 cases) and group B (27 cases) according to their treatment modes.Both groups were treated with incision and repositioning combined with ligament repair, group A used deltoid ligament repair, and group B used lower tibiofibular combined screw fixation repair. Observe the clinical efficacy and prognosis of the two groups.

Results

The hospital stay (15.66±2.12) and fracture healing time (11.44±2.00) in Group A were significantly shorter than those in Group B (18.70±2.45 and 13.56±2.01, respectively), with t-values of 5.022 and 3.986, and both P<0.05. Repeated measures ANOVA for VAS scores at 1 month and 3 months postoperatively between Group A and Group B showed statistically significant differences between the groups, with an interaction between group and time point. Differences between the two groups were statistically significant at all time points except preoperatively; the VAS scores in both Group A and Group B decreased in the order of 3 months postoperatively <1 month postoperatively < preoperatively (P<0.05). Additionally, the VAS scores in Group A were significantly lower than those in Group B at 1 month postoperatively (P<0.05). Repeated measures ANOVA for Baird-Jackson scores at 3 months and 6 months postoperatively between Group A and Group B also revealed statistically significant differences between the groups, with an interaction between group and time point. Differences between the two groups were statistically significant at all time points except preoperatively; the Baird-Jackson scores in both Group A and Group B increased in the order of preoperative <3 months postoperative <6 months postoperative (P<0.05). Furthermore, the Baird-Jackson scores in Group A were significantly higher than those in Group B at both 3 months and 6 months postoperatively (P<0.05). At 6 months postoperatively, the excellent and good rate in Group A (93.33%) was significantly higher than that in Group B (62.96%) (P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups (P>0.05).

Conclusions

Compared with lower tibiosis combined screw fixation repair, trigonal ligament repair showed significant advantages in length of hospitalization, fracture healing time, pain relief, recovery of ankle joint function, and excellent rate.

表1 两组踝关节骨折合并下胫腓前韧带断裂患者一般资料比较
图1 患者男,61岁,术前术后影像图。图A、B X线示患者左内、外踝骨质断裂。图C、D X线示患者术后解剖复位,左侧三踝钛针固定
表2 两组踝关节骨折合并下胫腓前韧带断裂患者围术期指标比较(±s
表3 不同时点踝关节骨折合并下胫腓前韧带断裂患者VAS评分对比(分,±s
表4 不同时点踝关节骨折合并下胫腓前韧带断裂患者Baird-Jackson评分对比(分,±s
表5 术后3个月时踝关节骨折合并下胫腓前韧带断裂患者踝关节功能优良率比较[例(%)]
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