仿生修复治疗旋后外旋型踝关节骨折中下胫腓联合韧带损伤

摘要

Objective:To evaluate the curative effect of biomimetic-rebuild cortical bone anchor fixation in distal tibiofibular syndesmotic injury in supina-tion external rotation ankle fractures.Methods:Retrospective analysis was performed in 58 cases of supination-eternal rotation ankle fractures(fracture de-gree:Ⅲ-Ⅳ) undergone in our hospital between August 2012 and January 2015.The patients were allocated to two groups by screw fixation and biomimet-ic-rebuild cortical bone anchor fixation ,and assessed regarding the operative time ,ankle function restoration by Baird-Jackson scores and tibiofibular clear space on anterior-posterior ankle joint X-rays.Results:Patients with screw fixation had longer operative time and higher scores on Baird-Jackson system by final follow-up than those treated with biomimetic-rebuild cortical bone anchor fixation(P<0.05).The two groups were not significantly different in tibiofib-ular clear space on anterior-posterior ankle joint X-rays(P>0.05),however,the difference was significant between groups by final follow-up(P<0.05). Conclusion:Biomimetic-rebuild cortical bone anchor fixation for distal tibiofibular syndesmotic injury in supination external rotation-type ankle fracture may lead to better ankle joint stability and function restoration than conventional screw fixation .%目的：探讨带线骨锚钉仿生修复治疗旋后外旋型踝关节骨折伴发的下胫腓联合韧带损伤的临床疗效。方法：回顾性分析安徽医科大学第三附属医院2012年8月～2015年1月收治的旋后外旋型踝关节骨折Ⅲ／Ⅳ度并发下胫腓联合韧带损伤患者58例，按照皮质骨螺钉固定和带线骨锚钉仿生修复两种治疗方式分组，评价指标：手术时间、踝关节Baird-Jackson功能评分，下胫腓联合间隙距离。结果：骨锚钉修复组平均手术时间延长，差异有统计学意义（ P＜0．05）。末次复查时Baird-Jackson踝关节功能评分骨锚钉修复组获得较高的平均得分，差异有统计学意义（ P＜0．05）。术后3个月踝关节正位X片的下胫腓关节间隙，两组差异无统计学意义（ P＞0．05）；末次随访时比较，两组差异有统计学意义（ P＜0．05）。结论：相较于螺钉固定，骨锚钉仿生修复治疗旋后外旋型踝关节骨折伴发的下胫腓联合韧带损伤，可以增加术后踝关节的稳定性，获得更好的关节功能。