两种手术方式治疗踝关节骨折合并三角韧带损伤的疗效比较OA

Objective To compare the efficacy of two surgical methods in the treatment of ankle frac-tures combined with deltoid ligament injuries.Methods A retrospective analysis was performed on the clini-cal data of 86 patients with supination external rotation Ⅳ(SER-Ⅳ)ankle fractures combined with deltoid liga-ment injuries who underwent surgical treatment in our hospital from January 2022 to September 2023.According to different treatment methods,the 86 patients were divided into an observation group(44 cases)and a control group(42 cases).The observation group received arthroscopic exploration and debridement of the ankle joint,suture anchor repair of the deltoid ligaments combined with open reduction and internal fixation(ORIF)for an-kle fractures.The control group underwent ORIF for ankle fractures with conservative management of the deltoid ligaments.The clinical outcomes were compared between the two groups,including the visual analogue scale(VAS),American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score at 6,12 and 18 months postoperatively,as well as the medial clear space(MCS)at 18 months postoperatively.Results All patients achieved primary wound healing postoperatively.Anatomical reduction and satisfactory fracture union were obtained in all cases,with no complications such as neurovascular injury,implant failure,refracture,or deep vein thrombosis of the lower extremity.There were no significant differences in VAS or AOFAS between the two groups at 6 and 12 months postoperatively(P>0.05).However,the observation group showed superior perform-ance in VAS,AOFAS,and MCS at 18 months postoperatively(P<0.05).Conclusion Arthroscopic explora-tion and debridement of the ankle joint,combined with suture anchor repair of the deltoid ligament and ORIF for ankle fractures,is a feasible and effective treatment for ankle fractures complicated with deltoid ligament injuries.