三踝骨折手术复位内固定顺序选择的临床研究Clinical study on sequence selection of reduction and internal fixation of the fracture of the ankle.pdfVIP

提 要 目的：观察分别按外踝-后踝-内踝的顺序，后踝-外踝-内踝的顺序和内踝-后踝- 外踝的顺序进行三踝骨折手术复位内固定过程中，手术时间及术中出血量的情况，希 望为以后三踝骨折手术复位内固定顺序的合理选择提供参考依据。 方法：按标准选出 40 病例纳入观察，按照复位内固定顺序的不同分为 3 组，按 外踝-后踝-内踝的顺序进行复位内固定组即 A 组13例，按后踝-外踝-内踝的顺序进 行复位内固定组即 B 组13例，按内踝-后踝-外踝的顺序进行复位内固定组即 C 组14 例。观察三组病例中患者的年龄、性别、患肢情况、手术所需时间，术中出血量、住 院时间、骨折临床愈合时间以及术后6个月后Mazur 踝关节功能评分情况等指标。统 计各指标的数据并用统计学软件进行处理。 结果：三踝骨折选用外踝-后踝-内踝的顺序行复位内固定组所用手术时间较其他 两组短，术中出血量少，但各组在骨折临床愈合时间以及后期踝关节功能恢复方面无 统计学显著性差异。 结论：三踝骨折选用外踝-后踝-内踝的顺序行复位内固定有利于降低手术难度， 缩短手术时间，减小手术性损伤以至减少术中出血量，是一种良好的术式选择。 关键词 三踝骨折；手术治疗；复位内固定顺序；对比性分析 The clinical study of the electic sequence of reduction and internal fixation in three ankles fractures operation Specialty: Orthopedics of TCM Author: Xiang Feng Tutor: Prof. Sun Lu Abstract Objective: To observe the operation time and the amount of bleeding in the operation in the process of reduction and internal fixation of three ankles fractures operation with the sequence of lateral malleolus first,hock second,malleolus medialis last and the sequence of hock first,lateral malleolus second,malleolus medialis last and the sequence of malleolus medialis first,hock second,lateral malleolus last,hoping to provide reference for the electic sequence of reduction and internal fixation in three ankle fractures operation in the future. Methords: Selected 40 cases,which is divided into 3 groups in accordance with the sequence of fixation, into the observation according to the standard.Group A, including 13 cases,is treated with the sequence of lateral malleolus first,hock second,malleolus medialis last;Group B, including 13 cases,is treated with the sequence of hock first,lateral malleolus second,malleolus medialis last;Group C, including 14 cases,is treated with the sequence of malleolus medialis first,hoc