【摘 要】
：
目的 分析踝关节骨折切开复位内固定后下胫腓联合分离固定和未固定的差异及对踝关节功能、疼痛度的影响.方法 选取2018年1月至2020年12月南京市江宁医院收治的106例踝关节骨折合并下胫腓联合分离患者为研究对象,以随机数表法分为两组,A组在踝关节骨折切开复位内固定术后固定下胫腓联合分离,B组未固定下胫腓联合分离,对比两组临床疗效、治疗前后下胫腓重叠距离(lower tibia and fibula overlap distance,TBOL)、下胫腓间隙(tibiofibular space,TBCS)、
【机 构】
：
南京市江宁医院骨科,江苏 南京 211100
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目的 分析踝关节骨折切开复位内固定后下胫腓联合分离固定和未固定的差异及对踝关节功能、疼痛度的影响.方法 选取2018年1月至2020年12月南京市江宁医院收治的106例踝关节骨折合并下胫腓联合分离患者为研究对象,以随机数表法分为两组,A组在踝关节骨折切开复位内固定术后固定下胫腓联合分离,B组未固定下胫腓联合分离,对比两组临床疗效、治疗前后下胫腓重叠距离(lower tibia and fibula overlap distance,TBOL)、下胫腓间隙(tibiofibular space,TBCS)、视觉模拟疼痛(visual analogue scale,VAS)评分、Baird-Jackson踝关节功能评分.结果 治疗后,A组优良率为92.45％,B组为90.57％,差异无统计学意义(x2=0.121,P>0.05);A组术后TBOL、TBCS分别为(8.52±1.15)mm、(3.41±0.15)mm,与B组的(8.49±1.13)mm、(3.45±0.13)mm比较,差异无统计学意义(t分别为0.135、1.467,P>0.05);A组术后Baird-Jackson踝关节功能评分为(95.02±1.05)分,与B组的(95.05±1.03)分比较,差异无统计学意义(t=0.000,P>0.05);A组术后VAS评分为(3.12±0.15)分,与B组的(3.09±0.13)分比较,差异无统计学意义(t=1.100,P>0.05).结论 在内、外踝等结构固定、复位效果满意的情况下,下胫腓联合固定与否对踝关节解剖结构、功能的影响不大,应以术中踝关节稳定性结构恢复情况为依据,决定踝关节骨折切开复位内固定后是否进行下胫腓联合分离固定.
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