医学研究与教育 ›› 2020, Vol. 37 ›› Issue (2): 44-48.DOI: 10.3969/j.issn.1674-490X.2020.02.007

• 临床医学 • 上一篇    下一篇

后外侧切开复位内固定配合中药对旋后外旋Ⅳ度踝关节骨折的治疗效果分析

刘大鹏,蒋殿伟   

  1. 丰宁县中医院外科, 河北 丰宁 068350
  • 收稿日期:2019-09-23 出版日期:2020-04-25 发布日期:2020-04-25
  • 作者简介:刘大鹏(1982—),男,河北丰宁人,主治医师,主要从事创伤骨科治疗和研究。 E-mail: hongdi3530@163.com

  • Received:2019-09-23 Online:2020-04-25 Published:2020-04-25

摘要: 目的 探讨后外侧切口切开复位内固定与中药配合对旋后外旋Ⅳ度踝关节骨折的治疗效果。方法 选取2016年1月至2018年6月收治的旋后外旋Ⅳ度踝关节骨折患者80例,随机分成观察组和对照组,各40例。2组均给予后外侧切开复位内固定治疗骨折,手术后对照组给予常规治疗,观察组配合中药汤剂内服治疗,观察2组手术指标恢复情况,随访52周,观察治疗26周后AOFAS踝-后足功能评分情况。结果 观察组止痛时间、消肿时间、骨折愈合时间、关节功能恢复时间分别为(5.71±0.96)d、(6.14±1.03)d、(50.83±8.17)d、(65.24±6.28)d;对照组为(6.62±1.77)d、(7.24±1.69)d、(71.02±10.26)d、(77.13±11.48)d;2组以上手术恢复指标比较,观察组均明显优于对照组,差异有统计学意义(P<0.05);随访26周后,观察组AOFAS评分优22例,良15例,可3例,优良率92.50%;对照组AOFAS评分优16例,良14例,可10例,优良率75.00%;2组AOFAS评分优良率比较,观察组显著高于对照组,差异有统计学意义(P<0.05)。观察组出现并发症4例,发生率10.0%,出现不遵医嘱或抗拒服药4例,治疗依从性90.00%;对照组出现并发症11例,发生率27.50%,治疗期间出现不遵医嘱或拒绝治疗12例,治疗依从性70.00%;观察组明显优于对照组,差异有统计学意义(P<0.05)。结论 对于治疗旋后外旋Ⅳ度踝关节骨折,切开复位内固定配合中药治疗不仅并发症低,患者的依从性高,并且能够明显缩短手术后各项指标恢复时间,还能显著改善踝关节功能,与术后常规治疗比较,具有明显优势。

关键词: 切开复位, 内固定, 中药, 骨折

Abstract: Objective To explore the therapeutic effect of the post-outer incision incision reset with Chinese medicine in the treatment effect of the spin IV-ankle fracture. Methods 80 cases of post-spin IV ankle fracture patients admitted to our hospital from January 2016 to June 2018 were selected into the study, and 40 cases were randomly divided into observation group and control group. Both groups were given post-outer incision reset fixed treatment fractures, after surgery the patients of the control group were given routine treatment, the patients of the observation group given Chinese medicine soup in-service treatment, the recoveries of two sets of surgical indicators were observed after follow-up 52 weeks, AOFAS ankle and posterior foot scoring function were observed after treatment for 26 weeks. Results The pain relief time, deflating time, fracture healing time and joint function recovery time were(5.71±0.96)d,(6.14±1.03)d,(50.83±8.17)d,(65.24±6.28)d. The control group was(6.62±1.77)d,(7.24±1.69),(71.02±10.26)d,(77.13±11.48)d. Compared with the surgical recovery index of two groups, the observation group was significantly better than that of the control group, and the difference was statistically significant(P<0.05). After 26 weeksof follow-up study, observation group indicated that AOFAS scores in 22 cases were excellent, 15 cases good, 3 cases not bad, the excellent and good treating effect rate was up to 92.50%. The treating effects of patients of the control group showed that AOFAS scores in 16 cases were excellent, 14 cases good, 10 cases not bad, the excellent and good treating effects were 75.00%. The two groups had a high rate of AOFAS score, but the observation group was significantly higher than the control group, and the difference was statistically significant(P<0.05). In the observation group, 4 patients had complications, the incidence rate was 10.0%, 4 patients had drug resistance, and the treatment compliance was 90.00%. There were 11 cases of complications in the control group, with an incidence rate of 27.50%. During the treatment, 12 cases took medicine against the doctor's advice, and the treatment compliance was 70.00%. Conclusion For treating supination extorsion Ⅳ°ankle fractures, open reduction and internal fixation with Chinese medicine treatment has obvious advantages,the complications are low. Compared with regular treatment, it is not only welcomed in patients,which can significantly shorten the recovery time after the surgery, but also can significantly improve the ankle functions.

Key words: cut the reset, inner fixation, Chinese medicine, fracture

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