可吸收螺钉与金属螺钉内固定治疗下胫腓联合损伤的临床疗效比较

Comparison between absorbable screw and metallic screw fixation for tibiofibular syndesmotic disruption

摘要:

分析可吸收螺钉和金属螺钉内固定治疗下胫腓联合损伤的临床疗效。方法选取2011年8月-2014年9月在该院接受手术治疗的下胫腓联合损伤患者作为研究对象。根据手术方式不同，分为吸收螺钉组54例和金属螺钉组52例。比较两组患者治疗后踝关节活动度及X线测量结果、踝关节评分、异物反应等。结果可吸收螺钉组患者的背屈角度、跖屈角度大于金属螺钉组（p <0.05），两组腓骨的重叠阴影、下胫腓联合间隙值比较，差异无统计学意义（p >0.05）；可吸收螺钉组患者的踝后足评分系统的评分值、踝关节稳定性、行走能力、奔跑能力、工作能力、踝关节活动度、影像结果评分高于金属螺钉组患者，疼痛评分低于金属螺钉组患者（p <0.05）；可吸收螺钉组患者的治疗后异物反应较轻，切口不愈合、切口感染、二次内固定手术等不良事件发生率低于金属螺钉组患者（p <0.05）。结论可吸收螺钉内固定是治疗下胫腓联合损伤的有效方式，具有高生物相容性及可降解特性，具有一定的临床应用优势。

Abstract:

To analyze the difference in clinical effect between absorbable screw and metallic screw fixation for tibiofibular syndesmotic injury. Methods The patients with tibiofibular syndesmotic disruption treated in our hospital between August 2011 and September 2014 were chosen as research subjects and divided into absorbable screw group (54 cases) and metal screw group (52 cases) according to surgery mode. Ankle mobility and X-ray measurements, ankle score and foreign body reaction were compared between the two groups. Results The anlke dorsiflexion and plantar flexion angles in the patients of the absorbable screw group were greater than those in the patients of the metal screw group (p <0.05), but neither tibiofibular overlap (TFO) nor tibiofibular clear space (TFCS) value of the two groups had significant difference (p > 0.05). Compared to the metal screw group, the AOFAS scores were higher, the pain score was lower, and the ankle stability,walk and run abilities, work capacity, ankle mobility and imaging results were better in the absorbable screw group (p < 0.05). Compared to the metal screw group, the foreign body reaction was milder, the rates of inci-sion disunion, wound infection and secondary internal fixation were lower in the absorbable screw group (p <0.05). Conclusions Absorbable screw internal fixation is an effective way to treat tibiofibular syndesmotic injury. Its high biocompatibility and biodegradability characteristics can help to promote healing and reduce secondary trauma.