手法整复与手术治疗老年人踝关节旋后外旋IV型骨折

目的比较老年人踝关节旋后外旋IV型骨折的手法整复与手术治疗效果。 方法回顾性分析青海省人民医院于2016年2月至2017年6月收治的老年踝关节旋后外旋IV型骨折患者，按照纳入排除标准，共有54纳入本研究，手法整复组21人，手术治疗组33人。评估两组治疗后12个月的Mazur踝关节症状与功能评价分级、Leeds影像学评价分级。采用秩和检验比较两组之间的差异。 结果治疗后12个月，两组的Mazur踝关节症状与功能评价分级差异无明显统计学意义(Z＝－0.496，P>0.05)；手术治疗组的Leeds影像学评价分级明显优于手法整复组，差异具有统计学意义(Z＝－3.641，P<0.01)。 结论手法整复与手术治疗老年人踝关节旋后外旋IV型骨折，在治疗后12个月均可获得满意的踝关节症状及功能改善，但手法整复组的影像学复查结果差于手术治疗组。

Comparison of manual restitution and internal fixation with open reduction of elderly patients with ankle supination external rotation IV fracture

ObjectiveTo compare the effect of manual restitution and internal fixation with open reduction on the ankle supination external rotation IV fracture in the elderly. MethodsA retrospective analysis of ankle SER IV fractures treated in Qinghai Provincial People’s Hospital from February 2016 to June 2017 was performed. According to the inclusion and exclusion criteria, a total of 54 were included in the study, 21 in the manual restitution group and 33 in the surgical treatment group. Mazur ankle joint symptoms and functional evaluation grades and Leeds imaging evaluation grades were evaluated 12 months after the treatment. Differences between the two groups were compared using a rank-sum test. ResultsAt 12 months after the treatment, there was no significant difference in the grades of Mazur's ankle joint function and function evaluation between the two groups (Z=-0.496, P>0.05). The Leeds imaging evaluation grade of the surgical treatment group was significantly better than the manual restitution; the difference was statistically significant (Z=-3.641, P<0.01). ConclusionAt 12 months after treatment, satisfactory ankle joint symptoms and functional improvement can be obtained by both manual restitution and surgery, but the results of imaging review of the manual restitution are worse than surgery.