踝关节镜辅助3孔钢板双螺钉固定下胫腓联合术对Maisonneuve骨折患者足踝功能及疼痛应激反应的影响

目的探讨踝关节镜辅助3孔钢板双螺钉固定下胫腓联合术对Maisonneuve骨折患者足踝功能及疼痛应激反应的影响。方法选取2017年8月至2019年8月收治的Maisonneuve骨折患者76例,以抽签法将其随机分为对照组和观察组,各38例。对照组采用传统切开复位下胫腓双螺钉固定术,观察组采用踝关节镜辅助3孔钢板双螺钉固定下胫腓联合术。比较两组疼痛应激反应指标、凝血功能指标、足踝功能和疼痛程度。结果术后1 d,观察组的E、Cor、CRP水平均低于对照组(P<0.05)。术后1 d,观察组的PT、APTT长于对照组,FBG水平低于对照组(P<0.05)。术后6个月,观察组的AOFAS评分高于对照组,VAS评分低于对照组(P<0.05)。结论临床采用踝关节镜辅助3孔钢板双螺钉固定下胫腓联合术治疗Maisonneuve骨折,能够有效减轻疼痛应激反应,改善凝血功能,促进患者足踝功能快速恢复。

Effects of ankle arthroscopy-assisted 3-hole plate and double screw fixation of lower tibiofibular syndesmosis on the ankle function and pain stress response in patients with Maisonneuve fracture

Objective To explore the effects of ankle arthroscopy-assisted 3-hole plate and double screw fixation of lower tibiofibular syndesmosis on the ankle function and pain stress response in patients with Maisonneuve fracture.Methods A total of 76 patients with Maisonneuve fractures admitted from August 2017 to August 2019 were selected and randomly divided into control group and observation group by drawing lots,with 38 cases in each group.The control group was treated with traditional open reduction and tibiofibular double screw fixation,and the observation group was treated with ankle arthroscopy-assisted 3-hole plate and double screw fixation of lower tibiofibular syndesmosis.The pain stress reaction indexes,coagulation function indexes,ankle function and pain degree were compared between the two groups.Results At 1 d after operation,the levels of E,Cor and CRP of the observation group were lower than those of the control group(P<0.05).At 1 d after operation,the PT and APTT of the observation group were longer than those of the control group,FBG level was lower than that of the control group(P<0.05).At 6 months after operation,the AOFAS score of the observation group was higher than that of the control group,while the VAS score was lower than that in the control group(P<0.05).Conclusion Clinical treatment of Maisonneuve fractures with ankle arthroscopy-assisted 3-hole plate and double screw fixation of lower tibiofibular syndesmosis can effectively reduce the pain and stress response,improve the coagulation function,and promote the rapid recovery of the patients'ankle function.