后踝解剖钢板与空心螺钉用于后踝骨折的疗效对比

目的比较后踝解剖钢板与空心螺钉在治疗后踝骨折的临床效果,探索后踝骨折更为合理的手术固定方法。方法安徽医科大学附属宿州医院 2015年 1月至 2018年 12月累及后踝踝关节骨折 154例,其中采用后踝解剖钢板固定的 87例,空心螺钉固定 67例,从两组中抽取年龄范围为 24～45岁共 44例病人,每组 22例,空心螺钉固定为螺钉组,后踝解剖钢板固定为钢板组,比较两组手术时间、术后下床时间、踝关节 AOFAS(美国足与踝关节协会)踝-后足评分、骨折解剖愈合时间及末次随访的活动度。结果两组病人均获得术后全程随访,随访时间 12～14个月。钢板组手术时间( 82.14±2.34)min与螺钉组手术时间

Comparison of posterior ankle anatomical plate and hollow screw in the treatment of posterior ankle fracture

Objective To compare the clinical effects of posterior ankle anatomical plate and Hollow screw in the treatment of poste-rior ankle fracture, and to explore a more reasonable surgical fixation method for posterior ankle fracture.Methods One hundred and fifty-four patients with ankle fracture involving posterior ankle fracture were treated in Suzhou Hospital Affiliated to Anhui Medical Uni-versity from January 2015 to December 2018, including 87 cases fixed with posterior ankle anatomical plate and 67 cases fixed withHollow screw. A total of 44 patients aged 24-45 years were selected from the two groups, with 22 patients in each group. Hollow screwfixation was used as screw group and posterior ankle anatomical plate fixation was used as plate group. The operation time, postopera-tive time getting out of bed, Ankle AOFAS (American foot and ankle Association) ankle-hindfoot score, fracture anatomical healing time and mobility at the last follow-up were compared.Results All patients in the two groups were followed up for 12 to 14 months. Bycomparison, the operation time of the plate group was (82.14 ± 2.34) min and the operation time of the screw group was (80.95 ± 1.99)min, the AOFAS score of the plate group was (87.77 ± 1.82) and the screw group was (86.95 ± 1.95) at 6 months, the AOFAS score ofthe plate group was (91.68 ± 1.13) and the screw group was (92.05 ± 1.25), the last ankle range of motion (ROM) and anatomical heal-ing time in the plate group and the screw group were (92.81 ± 1.71) D and (93.05 ± 1.65) d, respectively, there was no significant differ-ence (P > 0.05). The time of getting out of bed after operation was (51.73 ± 2.62) days in the screw group and (43.59 ± 1.56) days in theplate group (P < 0.05). Three months after operation, there was significant difference in AOFAS score between steel plate group (76.41± 1.71) and screw group (71.45 ± 1.50).Conclusions Posterior ankle anatomical plate and Hollow screw can obtain the same progno-sis in the treatment of posterior ankle fracture, but posterior ankle plate fixation can make the patient get out of bed early after opera-tion, which is conducive to the early recovery of ankle function.