闭合复位与切开复位内固定治疗跖跗关节损伤的效果比较.docVIP

闭合复位与切开复位内固定治疗跖跗关节损伤的效果比较 　　[摘要] 目的 探?闭合复位内固定方式与切开复位内固定方式在治疗跖跗关节损伤中的效果。 方法 选取2010年1月～2016年5月湖北省恩施土家族苗族自治州民族医院收治的跖跗关节损伤患者54例，用随机数字表法将其分成闭合复位组和切开复位组，每组各27例，分别采用闭合复位内固定和切开复位内固定。比较分析患者关节的复位情况、AOFAS足功能评分及术后并发症发生率。 结果 所有患者均随访6个月，切开复位内固定患者术后解剖复位率明显高于闭合复位内固定患者，差异有统计学意义（P 0.05），但切开复位组晚期并发症少于闭合复位组，差异有统计学意义（P 0.05）。 结论 在跖跗关节损伤手术固定中应用切开复位方式效果更佳，可更好的恢复关节解剖关系，足功能恢复效果更好，晚期并发症相对较少，更值得骨科临床推广。 　　[关键词] 跖跗关节损伤；闭合复位内固定；切开复位内固定；AOFAS评分 　　[中图分类号] R687.3 [文献标识码] A [文章编号] 1673-7210（2017）01（c）-0102-04 　　[Abstract] Objective To investigate the effect of closed reduction and internal fixation as well as the open reduction and internal fixation for the treatment of Lisfranc joint injury. Methods From January 2010 to May 2016， 54 cases of Lisfranc joint injury patients admitted to National Hospital of Enshi Tujia and Miao Autonomous Prefecture were selected in the study. They were divided into closed reduction group and open reduction group， with 27 cases in each group， by the method of randomized number table. Closed reduction and internal fixation as well as the open reduction and internal fixation were adopted respectively in these two groups. The reduction condition at the joint of the patients， AOFAS foot function scoring and the occurrence of postoperative complications of the patients in these two groups were analyzed through comparison. Results A 6 months follow-up visit was conducted on all the patients to observe the condition of joint reduction of the patients in the two groups. It was found through comparison that the postoperative anatomic reduction rate of the patients in the open reduction and internal fixation group was obviously higher than that in the closed reduction and internal fixation group， the difference was statistically significant （P 0.05）， while the late complications of the patients in the open reduction and internal fixation group were less than those in the closed reduction and internal fixation group， the differences were statistically significant （P