术中同期韧带修复治疗踝关节骨折伴三角韧带断裂疗效及预后影响因素探讨

目的 探讨术中同期韧带修复治疗踝关节骨折伴三角韧带断裂疗效及预后影响因素.方法 回顾性分析溧阳市人民医院2016年1月至2018年12月收治踝关节骨折伴三角韧带断裂患者共183例临床资料,其中未行同期韧带修复者共48例设为A组,术中行同期韧带修复者135例设为B组,而B组根据修复方式分为浅层修复(54例),深层修复(4...

Clinical effects and prognostic factors investigation of simultaneous ligament repair in treatment of ankle fracture with deltoid ligament rupture

【Objective】To investigate the clinical effects and prognostic factors of simultaneous ligament repair in the treatment of ankle fracture with deltoid ligament rupture.【Methods】Clinical data of 183 cases of ankle fracture with deltoid ligament rupture were retrospectively chosen from January 2016 to December 2018 in our hospital and divided into 2 groups including A group(48 patients)without simultaneous ligament repair and B group(135 patients)with simultaneous ligament repair,and B group were divided into shallow repair(54 cases),deep repair(48 cases)and complete repair(33 cases)according to repair scheme.The intraoperative bleeding volume,hospital staying time,AOFAS score,VAS score,postoperative complications incidence and sagittal heel-to-ground angle of different groups were compared and the prognostic factors were analyzed by logistic regression model.【Results】The hospital staying time,VAS score,postoperative complications incidence and sagittal heel-to-ground angle of B group were significantly less than those of A group(P<0.05).The AOFAS score of B group were significantly larger than that of A group(P<0.05).The coronal and sagittal heel-to-ground angle of B group was larger than that of A group(P<0.05).The AOFAS score of deep group and complete group was significantly smaller than that of shallow group(P<0.05).The VAS score of deep group and complete group was significantly larger than that of shallow group(P<0.05).The postoperative complications incidence of complete group was significantly higher than that of shallow group(P<0.05).Univariate analysis by logistic regression model showed that age,combined with other injuries,time from injury to operation,deep and shallow repair were the influencing factors of clinical prognosis(P<0.05),while multivariate analysis showed that shallow repair was the independent protective factor for clinical prognosis(P<0.05).【Conclusion】Simultaneous ligament repair in the treatment of ankle fracture with deltoid ligament rupture can efficiently improve the clinical efficacy and biomechanical indexes of joints;and shallow repair of deltoid ligament should be more helpful to increase clinical benefits.