陈伟珑

[摘要] 目的 探究旋后外旋型Ⅲ、Ⅳ度踝关节骨折患者通过切开复位内固定与手法复位石膏托外固定治疗后取得的临床成效。 方法 选取我院2015年1月～2016年6月入院的旋后外旋型Ⅲ、Ⅳ度踝关节骨折患者80例，通过随机分组法分为手术组和手法组，每组40例。手术组治疗方法为切开复位内固定治疗，手法组为手法复位石膏托外固定治疗。 结果 在Ⅲ、Ⅳ度踝关节骨折患者优良率方面，手术组优良率分别为100%、100%，手法组分别为66.7%、78.9%，手术组明显优于手法组（P<0.05）。手术组患者生存质量，包括生理症状、躯体症状、睡眠状况及心理症状指标得分均明显优于手法组（P<0.05）。手术组治疗满意度（100%）明显比手法组（80%）高。 结论 旋后外旋型Ⅲ、Ⅳ度踝关节骨折患者通过切开复位内固定与手法复位石膏托外固定治疗后取得的临床成效均较显著，但与手法复位石膏托外固定相比，切开复位内固定治疗后，患者优良率和治疗满意度均明显增高，且患者生存质量状况明显改善。

[关键词] 切开复位内固定；手法复位石膏托外固定；旋后外旋型Ⅲ、Ⅳ度踝关节骨折

[中图分类号] R678.3 [文献标识码] A [文章编号] 2095-0616（2017）16-232-03

Effect of open reduction and internal fixation and external fixation with plaster splint in the treatment of patients with supination external rotation type

CHEN Weilong

Department of Oorthopedics，Zengcheng District Xintang hospital，Guangzhou 511340，China

[Abstract] Objective To investigate the clinical efficacy of external fixation and external fixation in patients with ankle joint fracture and external fixation. Methods 80 patients with ankle fractures were randomly divided into two groups： operation group （n=40） and manipulation group （n=40）. Patients in operation group were treated with open reduction and internal fixation. Patients in manipulation group were treated with external fixation. Results The excellent and good rate of patients with fracture of ankle in Ⅲ，Ⅳ degree in operation group were 100% and 100%，which were 66.7% and 78.9% in manipulation group respectively.The operation group was superior to the manipulation group（P<0.05）.The quality of life of patients in the operation group，including physical symptoms， physical symptoms，sleep status and psychological symptoms were significantly better than those in the manipulation group（P<0.05）.The satisfaction rate of operation group（100%） was significantly higher than that of manipulation group（80%）. Conclusion The clinical results of external fixation and reduction of plaster and external fixation in patients with ankle joint fractures of type Ⅲ and Ⅳ were significantly higher than those in the treatment of plaster cast after the reduction and internal fixation，the patients' excellent rate and treatment satisfaction were significantly increased， and the quality of life of patients improved significantly.

[Key words] Open reduction and internal fixation；Manipulative reduction and plaster external fixation；Supination and external rotation type to Ⅲ or Ⅳ degree

踝關节骨折是临床常见的骨性疾病，多由创伤等外力因素导致，降低患者生活质量，必须加强对患者的有效治疗[1-2]。本研究为探究旋后外旋型Ⅲ、Ⅳ度踝关节骨折患者通过切开复位内固定与手法复位石膏托外固定治疗后取得的临床成效，选取我院2015年1月～2016年6月入院的旋后外旋型Ⅲ、Ⅳ度踝关节骨折患者80例，具体报道如下。endprint

1 資料与方法

1.1 一般资料

选取我院2015年1月～2016年6月收治的旋后外旋型Ⅲ、Ⅳ度踝关节骨折患者80例，随机分为手术组和手法组，每组40例。手术组男性和女性分别为17例和23例，年龄20～60岁，平均（40±1.2）岁，疾病分型：18例Ⅲ度骨折患者，22例Ⅳ度骨折患者；手法组男性和女性分别为26例和14例，年龄25～70岁，平均（47±2.1）岁，疾病分型：21例Ⅲ度骨折患者，19例Ⅳ度骨折患者。在年龄、性别、疾病分型等方面，两组患者差异无统计学意义（P>0.05），可以予以有效研究。临床诊断标准：（1）两组患者均经X线射线、CT及实验室等检查确诊为踝关节骨折[3-4]；（……