Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing Medical University, 210006 Nanjing, China
Jt Dis Relat Surg. 2023;34(1):16-23. doi: 10.52312/jdrs.2023.814. Epub 2022 Dec 27.
This study aims to compare the therapeutic effects of fixation with fibular approach, fixation with posterolateral fibular approach, and conservative therapy on supination-lateral rotation ankle fractures.
A total of 189 patients (103 males, 86 females; mean age: 45.7±4.7 years; range, 40 to 51 years) with supination-lateral rotation ankle fractures treated in our hospital between March 2020 and March 2021 were included in this prospective study. The patients were assigned into conservative therapy, fibular approach, and posterolateral approach groups including 63 patients in each group. Clinical conservative therapy was performed for conservative therapy group, while fibular approach and posterolateral approach groups were given fixation with fibular approach and posterolateral fibular approach, respectively. Their routine parameters, body stress, ankle function, treatment efficacy and safety were compared.
The length of hospital stay was shorter in the fibular approach and posterolateral approach groups than the conservative therapy group, particularly in the fibular approach group (p<0.05). The pain stress and oxidative stress were lower in the fibular approach and posterolateral approach groups than the conservative therapy group, particularly in the posterolateral approach group (p<0.05). Compared to the conservative therapy group, the fibular approach and posterolateral approach groups had significantly recovered ankle function, with better recovery in the posterolateral approach group (p<0.05). The response rate was higher in the fibular approach and posterolateral approach groups than the conservative therapy group, being higher in the posterolateral approach group (p<0.05).
For patients with supination-lateral rotation ankle fractures, fixation with posterolateral fibular approach is more effective for expediting the recovery of ankle joints than conservative therapy and fixation with fibular approach, accompanied by higher safety.
本研究旨在比较腓骨入路固定、后外侧腓骨入路固定和保守治疗对旋后-外旋型踝关节骨折的治疗效果。
本前瞻性研究纳入了 2020 年 3 月至 2021 年 3 月期间我院收治的 189 例旋后-外旋型踝关节骨折患者（男 103 例，女 86 例；平均年龄：45.7±4.7 岁；范围：40 岁至 51 岁）。将患者分为保守治疗组、腓骨入路组和后外侧入路组，每组 63 例。保守治疗组采用临床保守治疗，腓骨入路组和后外侧入路组分别采用腓骨入路固定和后外侧腓骨入路固定。比较三组患者的一般参数、身体应激、踝关节功能、治疗效果和安全性。
与保守治疗组相比，腓骨入路组和后外侧入路组的住院时间更短，尤其是腓骨入路组（p<0.05）。与保守治疗组相比，腓骨入路组和后外侧入路组的疼痛应激和氧化应激更低，尤其是后外侧入路组（p<0.05）。与保守治疗组相比，腓骨入路组和后外侧入路组的踝关节功能恢复更好，后外侧入路组的恢复更好（p<0.05）。与保守治疗组相比，腓骨入路组和后外侧入路组的反应率更高，后外侧入路组的反应率更高（p<0.05）。
对于旋后-外旋型踝关节骨折患者，与保守治疗和腓骨入路固定相比，后外侧腓骨入路固定更有利于促进踝关节的恢复，且安全性更高。
