微创经皮内固定术与切开复位内固定术治疗复杂踝部骨折的疗效比较

摘要

Objective:To investigate the efficacy of minimally invasive percutaneous fixation (MIPF) and open reduction and internal fixation (ORIF) in the treatment of complex ankle fractures.Methods:90 patients with complex ankle fractures admitted in our hospital from January 2014 to January 2015 were selected and randomly divided into a control group and an observation group,with 45 cases in each group.The patients in the observation group received MIPF,while those in the control group received ORIF.The operation time,intraoperative blood loss,hospital days and expenses as well as the excellence rate of ankle fractures reduction,ankle function and the incidence of complications were compared between the two groups.Results:The operation time,intraoperative blood loss,hospital days and expenses in the observation group were significantly lower than those in the control group (P ＜0.05).There was no significant difference in the excellent rate of fractures reduction between the two groups at 1 week and 1 month postoperation (P ＞0.05).The ankle function scores (Baird-Jackson score and Mazur score) in the observation group were significantly higher than those in the control group (P ＜0.05).Conclusion:MIPF was superior to ORIF in the treatment of complex ankle fractures,with advantages of higher excellent rate,speedy recovery of ankle function and fewer complications.%目的:探讨微创经皮内固定术与切开复位内固定术治疗复杂踝部骨折的疗效.方法:选择2014年1月至2015年1月四川省遂宁市中心医院骨科收治的90例复杂踝部骨折患者,按随机数字表法分为对照组与观察组,每组45例.观察组采用微创经皮内固定术,对照组采用切开复位内固定术.比较两组各项临床指标、踝关节复位及踝关节功能情况.结果:观察组手术时间、术中出血量、住院时间及住院费用均低于对照组(均P ＜0.05).两组术后1周及术后1个月踝关节复位优良率比较差异无统计学意义(均P ＞0.05).治疗后,两组踝关节功能评分(Baird-Jackson评分、Mazur评分)明显高于治疗前(均P＜0.05),且观察组踝关节功能评分明显高于对照组(P＜0.05).两组并发症发生率比较差异无统计学意义(P＞0.05).结论:微创经皮内固定手术有利于术后的踝关节功能恢复,缩短患者住院时间,值得临床推广应用.