手术治疗踝关节骨折的回顾性分析

目的：总结踝关节骨折的临床特征,评价手术治疗的中长期效果,分析术后并发症的原因。方法：回顾性分析本院1996年1月-2008年1月手术治疗的踝关节骨折患者326例,随访225例患者,随访4～120月,平均（38.4±4.4）月,按照美国足踝足外科协会（AOFAS）后足评分系统及相关客观检查进行随访,并分析影响踝关节骨折预后的因素。结果：随访225例踝关节骨折患者,手术治疗的优良率为80.4%,其中68例患者术后VAS评分平均为（3.1±1.4）分,急诊手术与择期手术的优良率比较差异无统计学意义（P〉0.05）。结论：高能量损伤仍是导致踝关节骨折的最主要原因,年龄、性别、分型、骨折数目、类型、合并脱位、手术时机、复位质量对预后有显著性影响。

Surgical Treatment for Ankle Fracture:a Retrospective Analysis

Objective： To summarize on the clinical features of ankle fracture, the long-term outcomes after surgical intervention and causes of post- surgical complications. Methods： The hospital charts of 326 consecutive patients with ankle fractures treated operatively in our hospital between January 1996 and January 2008 were reviewed. 225 patients were followed up for 4 to 120 months （mean： 38.4, SD 4.4 months） with clinical examinations, questionnaire mails or telephone calls. A questionnaire covering the American Orthopedic Foot and Ankle Society Score （AOFAS） and some supplementary questions was used. Analysis of the prognosis-related factors affecting the surgical outcome was also carried out. Results： 225 cases of ankle fractures were followed-up. Excellent outcomes of surgery were found in 80.4% of the patients. The mean VAS score was 3.1 ± 1.4 in 68 patients whose VAS data were available. There was no statistical difference in excellent outcomes between patients treated with emergency surgery and elective surgery （P〉0.05）. Conclusions： High-energy trauma was the most common cause of ankle joint fracture. Age, gender, classifications, number of affected bones, Weber types, dislocation, timing of surgery and quality of bone reduction were significant factors related to prognosis.