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河北医学  2023, Vol. 29 Issue (8): 1377-1382    DOI: 10.3969/j.issn.1006-6233.2023.08.029
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改良前外侧入路联合改良后内侧入路治疗三踝骨折对踝关节稳定性及功能恢复的影响
凌坤1, 阳普山1, 唐洪1, 苟永胜2
1.四川省广元市中心医院骨一科, 四川 广元 628000
2.四川省成都市双流区第一人民医院骨科, 四川 成都 610299
Effect of Modified Anterolateral Approach Combined with Modified Posteromedial Approach on Stability and Functional Recovery of Ankle Joint in the Treatment of Trimalleolar Fracture
LING Kun, YANG Pushan, TANG Hong, et al
Guangyuan Central Hospital, Sichuan Guangyuan 628000, China
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摘要 目的: 探讨改良前外侧入路联合后内侧入路治疗三踝骨折对患者踝关节稳定性及功能恢复的影响。方法: 回顾性分析2017年1月至2021年12月在我院治疗的三踝骨折患者102例,按照手术方式的不同分为改良组49例(改良前外侧入路联合后内侧入路)和传统组53例(传统后外侧入路联合后内侧入路)。比较两组围术期相关指标、临床治疗疗效、切口并发症发生情况以及踝关节稳定性、踝关节功能恢复情况。结果: 改良组术中出血量、手术时间、手术至下床活动时间、骨折愈合时间明显低于传统组,差异具有统计学意义(P<0.05)。改良组的治疗优良率明显高于传统组,差异具有统计学意义(P<0.05);改良组的切口并发症发生率明显低于传统组(P<0.05)。两组Baird-Jackson评分比较,术后6个月>术后2个月>术后1个月>术前,差异具有统计学意义(P<0.05),且术后改良组明显较高,差异具有统计学意义(P<0.05);两组AOFAS评分比较,术后6个月>术后2个月>术后1个月>术前,差异具有统计学意义(P<0.05),且术后改良组明显较高,差异具有统计学意义(P<0.05)。结论: 改良前外侧入路联合改良后内侧入路治疗三踝骨折可更有效增加踝关节的稳定,促进踝关节功能恢复,治疗疗效更佳,且并发症少。
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凌坤
阳普山
唐洪
苟永胜
关键词 改良前外侧入路改良后内侧入路三踝骨折踝关节稳定性踝关节功能恢复    
AbstractObjective: To explore the impact of improved anterolateral approach combined with posterior medial approach on ankle stability and functional recovery in patients with trimalleolar fractures. Methods: A retrospective analysis was conducted on 102 patients with trimalleolar fractures treated in our hospital from January 2017 to December 2021. According to different surgical methods, they were divided into a modified group of 49 cases (modified anterolateral approach combined with posterior medial approach) and a traditional group of 53 cases (traditional posterior lateral approach combined with posterior medial approach). The perioperative related indicators, clinical treatment efficacy, incidence of incision complications, ankle stability, and recovery of ankle function were compared between the two groups. Results: The intraoperative bleeding volume, surgical time, time from surgery to bed activity, and fracture healing time in the improved group were significantly lower than those in the traditional group, with statistical significance (P<0.05). The excellent and good treatment rate of the improved group was significantly higher than that of the traditional group, and the difference was statistically significant (P<0.05); the incidence of incision complications in the improved group was significantly lower than that in the traditional group (P<0.05). The comparison of Baird Jackson scores between the two groups showed a statistically significant difference (P<0.05) at 6 months after surgery>2 months after surgery>1 month after surgery>before surgery, and the postoperative improvement group had a significantly higher score, with a statistically significant difference (P<0.05); the comparison of AOFAS scores between the two groups showed a statistically significant difference (P<0.05) at 6 months after surgery>2 months after surgery>1 month after surgery>before surgery, and the postoperative improvement group was significantly higher, with a statistically significant difference (P<0.05). Conclusion: The combination of modified anterior lateral approach and modified posterior medial approach for the treatment of trimalleolar fractures can more effectively increase ankle stability, promote ankle function recovery, and achieve better treatment efficacy with fewer complications.
Key wordsModified anterolateral approach    Modified posterior medial approach    Trimalleolar fractures    Ankle joint stability    Ankle joint function recovery
    
基金资助:2019年四川省卫生健康委员会科研课题,(编号:19PJ065)
引用本文:   
凌坤, 阳普山, 唐洪, 苟永胜. 改良前外侧入路联合改良后内侧入路治疗三踝骨折对踝关节稳定性及功能恢复的影响[J]. 河北医学, 2023, 29(8): 1377-1382.
LING Kun, YANG Pushan, TANG Hong, et al. Effect of Modified Anterolateral Approach Combined with Modified Posteromedial Approach on Stability and Functional Recovery of Ankle Joint in the Treatment of Trimalleolar Fracture. HeBei Med, 2023, 29(8): 1377-1382.
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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.08.029     或     http://www.hbyxzzs.cn/CN/Y2023/V29/I8/1377
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