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[1]張琪,成永忠,黃曉宇,等.閉合復位外固定架固定治療合并下脛腓聯(lián)合分離的旋前-外展型三踝骨折的穩(wěn)定性研究[J].中醫(yī)正骨,2020,32(02):14-18.
　ZHANG Qi,CHENG Yongzhong,HUANG Xiaoyu,et al.A study of stability of closed reduction and frame external fixation in the treatment of pronation-abduction-type trimalleolar fractures combined with distal tibiofibular syndesmosis separation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(02):14-18.
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閉合復位外固定架固定治療合并下脛腓聯(lián)合分離的旋前-外展型三踝骨折的穩(wěn)定性研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年02期
頁碼:
14-18
欄目:
基礎研究
出版日期:
2020-02-20

文章信息/Info

Title:
A study of stability of closed reduction and frame external fixation in the treatment of pronation-abduction-type trimalleolar fractures combined with distal tibiofibular syndesmosis separation
作者:
張琪; 成永忠; 黃曉宇; 陳奕歷; 溫建民; 蔡靜怡; 程灝; 李永耀; 許晶晶; 賀達
(中國中醫(yī)科學院望京醫(yī)院,北京 100102)
Author(s):
ZHANG Qi; CHENG Yongzhong; HUANG Xiaoyu; CHEN Yili; WEN Jianmin; CAI Jingyi; CHENG Hao; LI Yongyao; XU Jingjing; HE Da
Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China
關鍵詞:
踝關節(jié);  外固定器;  骨折固定術; 內(nèi);  下脛腓聯(lián)合;  解剖
Keywords:
Keywords ankle joint;  external fixators;  fracture fixation; internal;  distal tibiofibular syndesmosis;  dissection
摘要:
目的:評估閉合復位外固定架固定治療合并下脛腓聯(lián)合分離的旋前-外展型三踝骨折的穩(wěn)定性。方法:將7對踝關節(jié)標本行間斷骨鉆孔后根據(jù)受傷機制施加暴力,制備旋前-外展型三踝骨折模型14踝,其中3對(6踝)踝關節(jié)標本合并下脛腓聯(lián)合分離。將一側踝關節(jié)標本先進行閉合復位外固定架固定,再進行切開復位接骨板內(nèi)固定; 另一側踝關節(jié)標本先進行切開復位接骨板內(nèi)固定,再進行閉合復位外固定架固定。每次復位固定后,先后對模型施加10 Nm、15 Nm、20 Nm的扭矩外旋足踝,通過在X線片上測定下脛腓聯(lián)合間隙確定其穩(wěn)定性。執(zhí)行完一種固定方式的穩(wěn)定性測試后,將標本上固定的外固定架或內(nèi)固定物完全拆除,并將踝關節(jié)標本恢復至復位固定前的狀態(tài),然后進行另一種固定方式的穩(wěn)定性測試。比較不同扭矩下兩種固定方式對下脛腓聯(lián)合間隙的影響。結果:造模后雙側踝關節(jié)下脛腓聯(lián)合間隙比較,差異無統(tǒng)計學意義[(6.29±2.93)mm,(4.28±1.69)mm,t=0.378,P=0.540]。閉合復位外固定架固定和切開復位接骨板內(nèi)固定的合并下脛腓聯(lián)合分離的旋前-外展型三踝骨折,施加10 Nm、15 Nm、20 Nm扭矩后,兩組下脛腓聯(lián)合間隙的差異均無統(tǒng)計學意義[(5.72±2.46)mm,(5.29±3.58)mm,t=0.246,P=0.811;(5.69±2.72)mm,(6.98±3.05)mm,t=-0.773,P=0.458;(5.70±2.95)mm,(6.80±3.20)mm,t=-0.618,P=0.551]。結論:閉合復位外固定架固定治療合并下脛腓聯(lián)合分離的旋前-外展型三踝骨折,其穩(wěn)定性與切開復位接骨板內(nèi)固定相當。
Abstract:
Objective:To evaluate the stability of closed reduction and frame external fixation in treatment of pronation-abduction-type trimalleolar fractures combined with distal tibiofibular syndesmosis separation.Methods:The pronation-abduction-type trimalleolar fracture models(14 ankles)were made by applying violent force to ankle specimens(7 pairs)according to injury mechanism after intermittent bone drilling was performed,and distal tibiofibular syndesmosis separation was found in 3 pairs(6 ankles)of ankle specimens.One of a pair of ankle specimens was treated with closed reduction and frame external fixation,and then the treatment was replaced by open reduction and bone plate internal fixation; while the other one of a pair of ankle specimens was treated by the reversed sequence.After reduction and fixation,10,15 and 20 Nm-torques were applied to the models respectively to rotate the ankles outward,and then the stability was determined through measuring the distal tibiofibular syndesmosis interspaces on X-ray films.The two fixation methods were compared with each other in their effect on distal tibiofibular syndesmosis interspace under different torques.Results:There was no statistical difference in distal tibiofibular syndesmosis interspace between bilateral ankles after the modeling(6.29+/-2.93 vs 4.28+/-1.69 mm,t=0.378,P=0.540).For ankle specimens with pronation-abduction-type trimalleolar fracture and distal tibiofibular syndesmosis separation,there was no statistical difference in distal tibiofibular syndesmosis interspace between therapy of closed reduction and frame external fixation and therapy of open reduction and bone plate internal fixation after 10,15 and 20 Nm-torques were exerted on them respectively(5.72+/-2.46 vs 5.29+/-3.58 mm,t=0.246,P=0.811; 5.69+/-2.72 vs 6.98+/-3.05 mm,t=-0.773,P=0.458; 5.70+/-2.95 vs 6.80+/-3.20 mm,t=-0.618,P=0.551).Conclusion:Closed reduction and frame external fixation is similar to open reduction and bone plate internal fixation in stability in treatment of pronation-abduction-type trimalleolar fractures combined with distal tibiofibular syndesmosis separation.

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備注/Memo

備注/Memo:
(收稿日期:2019-08-27 本文編輯:李曉樂)基金項目:北京市自然科學基金項目(7172243) 通訊作者:成永忠 E-mail:[email protected]
更新日期/Last Update: 2020-02-15