摘要
目的探讨不同治疗方式在旋后外旋型Ⅲ、Ⅳ度踝关节骨折中的应用。方法选择我院收治的旋后外旋型Ⅲ、Ⅳ度踝关节骨折患者56例,根据治疗方式不同分为切开复位内固定的手术组以及手法复位石膏托外固定的保守治疗组,每组28例。对比2组患者Mazur评分、Leed评分及并发症发生情况。结果Ⅲ度踝关节骨折手术治疗优良率为93.8%,显著高于保守组77.8%(P<0.05),差异有统计学意义。手术组Ⅳ度优良率为75%与保守组Ⅳ度优良率70%比较,差异无统计学意义(P>0.05)。手术组Ⅲ度踝关节骨折治疗优良率为93.8%,保守组为83.3%,2组对比差异无统计学意义(P>0.05)。手术组Ⅳ度优良率为83.3%与保守组Ⅳ度优良率70%对比,差异无统计学意义(P>0.05)。手术组患者住院天数显著高于保守治疗组,2组对比差异有统计学意义(P<0.05)。2组患者都并发创伤性关节炎,但并发症差别对比无统计学意义。结论手术治疗及保守治疗对旋后外旋型Ⅲ、Ⅳ度踝关节骨折均有治疗效果,在Ⅲ度踝关节骨折中手术治疗效果更佳,而保守治疗住院天数少,治疗安全系数高。
Objective To investigate the application of different treatments in grade Ⅲ、Ⅳ supinaiton-eversion ankle fractures.Methods According to different treatments,56 patients in our hospital were divided into the operative group,28 patients with open reduction and internal fixation,and the conservative group,28 patients with manual reduction and plaster immobilization.The Mazur score,Leed score and complications of the two groups were compared.Results Compared Mazur score of the two groups,the excellent and good rate of grade Ⅲ in the operative group is 93.8% which is significantly higher than that in conservative group（77.8%）,the result has statistically significant difference（P0.05）.There was no significantly difference in excellent and good rate of grade Ⅳ between operative group and conservative group（P0.05）.Compared Leed score of the two groups,the excellent and good rate of grade Ⅲ in the operative group is 93.8% which is higher than that in conservative group（83.3%）,the result has no significant difference（P0.05）.There was no significant difference in excellent and good rate of grade Ⅳ between operative group（83.3%） and conservative group（70%）（P0.05）.The hospital stays of operative group was significantly more than those of conservative group,there was no statistically significant difference（P0.05）.Both of the two groups supervened with traumatic arthritis,and the difference was not significant.Conclusion Both operative and conservative treatment have curative effect in grade Ⅲ、Ⅳ supinaiton-eversion ankle fractures,and operative treatment is more effective for Ⅲ supinaiton-eversion ankle fractures,while conservative treatment with fewer hospital stays and safer.
出处
《局解手术学杂志》
2013年第1期53-54,57,共3页
Journal of Regional Anatomy and Operative Surgery
关键词
踝关节骨折
手术
保守治疗
内固定
手法复位
ankle fracture
operation
conservative treatment
internal fixation
manual reduction
