关键词: 踝关节骨折, 下胫腓前韧带断裂, 切开复位内固定术, 韧带修复, 疗效, 预后

Abstract: [Abstract] Objective Exploring the efficacy and prognostic analysis of open reduction and internal fixation combined with ligament repair in the treatment of ankle joint fractures with anterior tibiofibular ligament rupture.Methods Ninety-two patients with ankle fracture combined with lower tibiofibular anterior ligament rupture admitted to our hospital from January 2020 to August 2022 were selected to implement the prospective study,and they were divided into 46 cases in the study group and 46 cases in the control group according to the different treatment modalities.The control group only received open reduction and internal fixation surgery,while the research group received open reduction and internal fixation surgery combined with ligament repair treatment.The differences in surgical indicators and recovery,pain level (VAS score),ankle joint function recovery (AOFAS score,ankle ROM),bone metabolism indicators,postoperative complications,and long-term prognosis between the two groups were compared.Results Compared with the control group,the study group had longer operation time,shorter hospitalization time,and shorter fracture healing time ( P<0.05).Repeated measures showed that there were differences in the comparison of timepoint effects,between-group effects,and interaction effects of VAS scores ( P<0.05),and VAS scores were lower in both groups at 1 month and 3 months postoperatively compared with preoperatively,and were better in the study group than in the control group ( P<0.05).Compared with preoperative,AOFAS score and ankle ROM were increased in both groups at 6 months postoperatively,and the study group was better than the control group ( P<0.05).Compared with preoperative,collagen type Ⅰ N-terminal peptide (PINP),osteocalcin (BGP),bone alkaline phosphatase (BALP) were elevated in both groups at 6 months postoperatively,and the level of β-collagen degradation product (β-CTX) β-CTX was reduced in the former ( P<0.05);and the study group was better than the control group ( P<0.05).Compared with the control group,there was no significant difference in the comparison of postoperative complication status ( P>0.05),but the study group had a better long-term prognosis ( P<0.05).Conclusion The combination of open reduction and internal fixation surgery with ligament repair for the treatment of ankle fracture combined with anterior tibiofibular ligament rupture has good clinical efficacy,can effectively reduce pain,improve ankle function,regulate bone metabolism level,promote fracture healing,and has good safety and long-term prognosis.

Key words: ankle joint fracture, rupture of the anterior tibiofibular ligament, open reduction and internal fixation surgery, ligament repair, efficacy, prognosis