【摘要】 [目的]比较踝骨折伴三角韧带损伤开放复位内固定（open reduction and internal fixation, ORIF）术中是否修复三角韧带（deltoid ligament repair, DLR）的临床结果。[方法]回顾性分析2020年6月—2023年5月本科ORIF治疗踝关节骨折伴三角韧带损伤102患者的临床资料。据术前医患沟通结果，54例术中行DLR（修复组），48例术中未行DLR（未修复组）。比较两组围手术期、随访及影像指标。[结果] 102例患者均成功手术，修复组的手术时间[(110.0±12.7) min vs(104.2±12.0) min,P=0.020]、切口长度[(8.5±2.3) cm vs(6.8±1.9) cm, P<0.001]均显著长于未修复组，但前者的术中X线透视次数[(8.0±2.0)次vs(12.0±4.0)次, P<0.001]、住院时间[(13.5±3.1) d vs(17.2±2.8) d, P<0.001]及下地行走时间[(14.7±4.2) d vs(20.5±4.7) d, P<0.001]均显著优于未修复组。随访时间平均（19.5±3.8）个月，修复组恢复完全负重活动时间显著早于未修复组[(78.6±16.0) d vs(92.0±20.5) d, P<0.001]。末次随访时修复组的AOFAS评分[(93.5±5.0) vs(91.4±5.3), P=0.042]、足背伸-跖屈ROM[(16.0±2.5)°vs(14.5±2.4)°, P=0.003]及内-外翻ROM[(17.5±2.7)°vs(16.0±2.3)°, P=0.003]均显著优于未修复组。影像方面，修复组的骨折复位质量、距骨小腿角（talocrural angle, TCA）、术后即刻踝内侧净间隙（medial clear space, MCS）、胫腓净间隙（tibiofibular clear space, TFCS）均显著优于未修复组（P<0.05）。[结论]修复DL损伤能增强踝骨折ORIF的疗效，有利于踝关节功能改善。更多还原

【Abstract】 [Objective] To compare the clinical consequence open reduction and internal fixation(ORIF) with or without deltoid ligament repair(DLR) for ankle fractures complicated with deltoid ligament injury. [Methods] A retrospective study was conducted on 102 patients who underwent ORIF for ankle fractures complicated with deltoid ligament injury from June 2020 to May 2023. According to preoperative doctor-patient communication, 54 patients received DLR during the ORIF, while other 48 patients had ORIF only without DLR. The perioperative period, follow-up and imaging data were compared between the two groups. [Results] All the 102 patients were operated on successfully. Although the DLR group consumed significantly longer operative time [(110.0±12.7) min vs(104.2±12.0) min, P=0.020] and incision length [(8.5±2.3) cm vs(6.8±1.9) cm, P<0.001] than the non-DLR group, the former proved significantly superior to the latter in terms of intraoperative X-ray fluoroscopy times [(8.0±2.0) vs(12.0±4.0) times, P<0.001], hospital stay [(13.5±3.1) days vs(17.2±2.8) days,P<0.001] and ambulation time [(14.7±4.2) days vs(20.5±4.7) days, P<0.001]. The average follow-up time was of(19.5±3.8) months, and the DLR group resumed full weight-bearing activity significantly earlier than the non-DLR group [(78.6±16.0) days vs(92.0±20.5) days, P<0.001]. In addition, the DLR group was also significantly better than the non-DLR group in terms of AOFAS score [(93.5±5.0) vs(91.4±5.3), P=0.042], dorsal-plantar flexion ROM [(16.0±2.5)° vs(14.5±2.4)°, P=0.003] and inversion-eversion ROM [(17.5±2.7)° vs(16.0±2.3)°, P=0.003] at the latest follow-up. As for imaging, the DLR group was further proved significantly superior to the non-DLR group regarding fracture reduction quality, talocrural angle(TCA), medial clear space(MCS) and tibiofibular clear space(TFCS)(P<0.05). [Conclusion] Deltoid ligament repair does enhance the efficacy of ORIF and improve ankle joint function recovery for ankle fractures complicated with torn deltoid ligament.更多还原