【摘要】 目的 探讨切开复位内固定结合锁扣带袢钛板治疗踝关节骨折伴下胫腓联合损伤的疗效。方法 采用切开复位内固定结合锁扣带袢钛板治疗26例踝关节骨折伴下胫腓联合损伤患者。记录手术情况、术后疼痛VAS评分、下胫腓重叠影(TBOL)、胫腓联合间隙(TBCS)、踝关节背伸-跖屈活动范围，采用AOFAS踝-后足评分评估功能恢复情况，采用欧洲五维生活量表(EQ-5D)效用指数评估患者生活质量。结果 患者均获得1年随访。术中出血量50～100(76.4±11.2)ml,手术时间70～110(87.6±6.4)min,术后24 h疼痛VAS评分1～6(3.5±1.4)分、TBCS 3.6～5.2(4.4±0.4)mm、TBOL 6.8～8.6(7.6±0.4)mm。术后返回工作时间1～3(2.0±0.4)个月。骨折均愈合，时间2.5～3.0(2.8±0.2)个月。术后1年，踝关节背伸-跖屈活动范围45°～65°(55.0°±5.4°);AOFAS踝-后足评分73～95(87.2±5.7)分，其中优9例、良16例，可1例，优良率25/26;EQ-5D效用指数0.92～1.00(0.96±0.03)。术后1例踝关节疼痛，1例袢钛板部位骨部分溶解及袢钛板陷落。结论 切开复位内固定结合锁扣带袢钛板治疗踝关节骨折伴下胫腓联合损伤能获得较好的临床疗效，可满足患者早期功能锻炼需求，术后1年患者具有较高的生活质量和更好的关节活动度。更多还原

【Abstract】 Objective To explore the efficacy of open reduction and internal fixation combined with locking band loop titanium plate in the treatment of ankle fracture with distal tibiofibular syndesmosis injury.Methods The 26 patients with ankle fractures accompanied by distal tibiofibular syndesmosis injuries were treated with open reduction and internal fixation combined with locking band loop titanium plates. The surgical conditions, postoperative pain VAS, tibiofibular overlap(TBOL), tibiofibular clear space(TBCS), ankle dorsiflexion-plantar flexion range of motion were recorded. The functional recovery was evaluated by AOFAS ankle-hindfoot score, and the quality of life of patients was evaluated by Euroqol five-dimension questionnaire(EQ-5D) utility index. Results All patients were followed up for 1 year. The intraoperative blood loss was 50-100(76.4±11.2) ml, the operation time was 70-110(87.6±6.4) min, the postoperative 24-hour pain VAS was 1-6(3.5±1.4) points, TBCS was 3.6-5.2(4.4±0.4) mm, TBOL was 6.8-8.6(7.6±0.4) mm. The time to return to work after surgery was 1-3(2.0±0.4) months. The fractures healed completely, with a healing time of 2.5-3.0(2.8±0.2) months. One year after surgery, the ankle dorsiflexion-plantar flexion range of motion was 45°-65°(55.0°±5.4°); the AOFAS ankle-hindfoot scores were 73-95(87.2±5.7) points, including 9 excellent cases, 16 good cases, and 1 fair case, with an excellent-good rate of 25/26; the EQ-5D utility index was 0.92-1.00(0.96±0.03). One patient had ankle pain after surgery, and 1 patient had partial bone dissolution and collapse of the locking band loop titanium plate.Conclusions Open reduction and internal fixation combined with locking band loop titanium plate for ankle fractures with distal tibiofibular syndesmosis injury can achieve good clinical efficacy, meet the needs of patients for early functional exercise, patients have a higher quality of life and better joint range of motion at 1 year after surgery.更多还原