可吸收螺钉和皮质骨螺钉治疗下胫腓联合损伤疗效的对比研究

摘要

Objective To compare the effect of absorbable screws and cortical screws fixation on distal tibiofibular syndesmosis injury,and provide a theoretical basis for the choice of internal fixation for tibiofibular syndesmosis injury.Methods Forty-seven patients with distal tibiofibular syndesmosis injury admitted to orthopedic department of Shanghai NO.8 People's Hospital from Aug.2007 to Jan.2011 were randomly(random-number table)divided into two groups,24 patients used absorbable screws for fixation (group A),23cases used cortical bone screws for fixation (group B) ; all the patients were assessed in aspects of radiography and therapeutic effects during follow-up.Results The X-rays of all the patients after surgery showed normal ankle hole position.After 1 year of follow-up,the indexes including Baird score,total score,and Baird grade were not statistically different between the two groups (P ＞ 0.05).Conclusion The clinical efficacy of absorbable screws on distal tibiofibular syndesmosis injury is similar to that of cortical screws fixation,but the absorbable screw fixation is biocompatible,which does not need the second surgery and worthy of clinical application,though due attention should be paid to the complications.%目的 比较可吸收螺钉和皮质骨螺钉类固定治疗下胫腓骨联合损伤的临床疗效,为下腓骨联合损伤内固定物的选择提供理论依据.方法 选取2007年8月至2011年1月上海市第八人民医院骨科收入院的47例下胫腓联合损伤患者,按随机数字表法分为两组:A组(24例)采用可吸收螺钉内固定治疗；B组(23例)采用皮质骨螺钉固定治疗.术后进行影像学检查,并对治疗效果进行评估.结果 术后X线片复查提示踝穴恢复正常关系.随访1年后两组间Baird评分各项指标、总分,Baird评级、优良率差异均无统计学意义(P＞0.05).结论 可吸收螺钉可达到与皮质骨螺钉相同的固定效果,而且可吸收螺钉生物相容性好,无需二次手术,值得临床推广,与此同时也需重视其并发症.