带线锚钉修复三角韧带断裂在踝关节骨折行内固定手术的应用价值

目的探讨切开复位内固定联合带线锚钉修复治疗踝关节骨折合并三角韧带断裂的临床优势。方法回顾性分析踝关节骨折并三角韧带断裂病人72例资料，均予以切开复位内固定手术治疗。其中，36例术中采用带线锚钉修复三角韧带（观察组）；另36例术中未修复三角韧带（对照组）。2组病人术后均获随访6~16个月，对其进行相关指标的疗效对比分析。结果全部病人均手术顺利，骨折复位良好。2组踝穴内侧距离差异有统计学意义（P < 0.05）。对照组术后6例发生踝关节内侧不稳，3例踝关节跖屈活动明显受限，观察组无一例发生踝关节内侧不稳和螺钉脱出等并发症。观察组的踝关节跖屈和背伸活动度均优于对照组（P < 0.01）。观察组AOFAS踝-后足功能评分显著高于对照组（P < 0.01）；观察组总优良率为86.1%，对照组为75.0%，2组差异无统计学意义（P>0.05）。结论采用切开复位内固定联合带线锚钉修复治疗踝关节骨折合并三角韧带断裂，能够提高踝关节稳定性，有助于恢复踝关节活动度。

Application value of wire anchor in repairing triangular ligament rupture in ankle fracture treated with internal fixation

ObjectiveTo explore the clinical advantages of open reduction and internal fixation combined with wire anchor in the treatment of ankle fracture complicated with deltoid ligament rupture.MethodsThe clinical data of 72 patients with ankle fracture complicated with deltoid ligament rupture treated with open reduction and internal fixation were retrospectively analyzed.Thirty-six deltoid ligament rupture cases repaired with wire anchor and 36 deltoid ligament rupture cases without repair were divided into the observation group and control group, respectively.Two groups were followed up for 6 to 16 months, and the therapeutic effects of the related indicators were compared between two groups.ResultsThe operations in all cases were successful, and the fracture reduction in two groups was good.The difference of the medial distance of ankle points between two groups was statistically significant(P < 0.05).Six cases with medial instability of ankle joint in control group after operation were found, and the movement of plantar flexion in 3 cases of control group was obviously limited.No medial instability of ankle joint and screw out in observation group were found.The motion range of ankle metatarsal flexion and dorsiflexion in observation group were better than those in control group(P < 0.01).The AOFAS ankle-hind foot function score in observation group was significantly higher than that in control group(P < 0.01).The total excellent and good rate in observation group and control group were 86.1% and 75.0%, respectively, and the difference of which was not statistically significant(P>0.05).ConclusionsOpen reduction and internal fixation combined with wire anchor in repairing ankle fracture complicated with deltoid ligament rupture can improve the ankle stability, and help to restore the ankle mobility.