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论著:锚钉修复外踝骨折合并三角韧带损伤的疗效
Application of Suture Anchors in the Treatment of Lateral Malleolus Fractures Associated with Deltoid Ligament Injuries
丁磊 吴靖平 李德芳 曾庆敏
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作者单位:复旦大学附属金山医院骨科
中文关键字:带线锚钉;外踝骨折;三角韧带
英文关键字:Suture anchor; Distal fibular fracture; Deltoid ligament
中文摘要:目的:探讨锚钉修复外踝骨折合并三角韧带损伤的疗效。方法:对29例外踝骨折合并三角韧带损伤的患者均行外踝骨折内固定,同时对其中14例患者行三角韧带修复(手术修补组),对其余15例未行三角韧带修复(对照组)。术前采用重力位X线测距骨倾斜角度评估三角韧带损伤,术后11~16周采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society, AOFAS)评分评估关节的临床功能,术后1年再次采用重力位X线片测距骨倾斜角度。结果:29例患者均获随访,修补组和对照组术前距骨倾斜角度分别为(11.57±0.97)°和(12.02±1.06)°,两组比较差异无统计学意义(P>0.05);术后11~16周AOFAS功能评分显示,修补组和对照组的优良率分别为85.7%和53.3%(P<0.05);1年后修补组和对照组距骨倾斜角度分别为(1.28±0.11)°和(5.88±0.61)°,两组比较有显著性差异(P<0.05)。结论:在骨折内固定的同时应充分重视三角韧带修复。
英文摘要:Objective: To assess the curative effects of suture anchors in the treatment of lateral malleolus fractures associated with deltoid ligament injuries. Methods:A total of 29 patients with lateral malleolus fractures associated with deltoid ligament injuries have been enrolled in this study. All of them were treated with open reduction and internal fixation. The injured deltoid ligaments in 14 cases were treated by using suture anchors (the repaired group), while the other 15 cases were treated without repairing deltoid ligaments(the control group). Gravity stress radiography was utilized to estimate the integrity of deltoid ligaments. All the patients were evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system 14 16 weeks after operation, and the talar tilts in the two groups pre operation and post operation were measured. Results: All the 29 patients have been followed up. There were no significant differences in pre operation talar tilts between the repaired group (11.57±0.97)° and the control group (12.02±1.06)°. After one year, talar tilts of the repaired group and the control group were (1.28±0.11)° and (5.88±0.61)°, respectively (P<0.05). According to the AOFAS scoring system, the excellent and good rates were 85.7% in the repaired group and 53.3 % in the control group (P<0.05). Conclusions: Restoration of the deltoid ligaments was as important as open reduction and internal fixation of the lateral malleolus.
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