外固定结合运动疗法治疗下胫腓联合损伤效果探析.doc

外固定结合运动疗法治疗下胫腓联合损伤效果探析 　　[摘要]目的 观察不同外固定方法结合运动疗法治疗下胫腓联合损伤的临床效果。方法 将2013年6月～2015年6月收集的佛山市中医院40例下胫腓联合损伤患者，通过随机数字表法分为观察组（20例）和对照组（20例），分别接受超踝杉树皮小夹板固定和U形石膏托固定，同时结合运动疗法治疗，采用Kofoed评分、AOFAS踝-后足评分量表对患者受伤踝关节初诊、伤后2周、伤后2个月、伤后6个月的功能进行评价，复查X线片评价下胫腓联合是否分离。结果 两组Kofoed评分、AOFAS踝-后足评分比较，差异无统计学意义（P0.05），两组均无下胫腓联合分离，但杉树皮小夹板舒适性较好且利于早期消肿。结论 两种外固定方法结合运动疗法治疗下胫腓联合损伤均可获得良好效果，但中医杉树皮小夹板具有较好的舒适性和有利于早期消肿及关节微动的优点，值得临床推广应用 [关键词]下胫腓联合损伤；杉树皮小夹板；外固定；石膏托 [中图分类号] R274.9 [文献标识码] A [文章编号] 1674-4721（2017）02（a）-0099-04 [Abstract]Objective To observe effect of different external fixation combined with exercise therapy in the treatment of distal tibiofibular syndesmosis injury.Methods 40 patients of distal tibiofibular syndesmosis injury in Foshan Hospital of TCM from June 2013 to June 2015 were collected and divided into observation group （20 cases） and control group （20 cases） by random number table method.Patients were treated with wood splint or U-shaped plaster combined with exercise therapy respectively，Kofoed Scale and AOFAS Ankle Hindfoot Scale were used to evaluate the function of injured ankle joint at the first visit，2 weeks，2 months，6 months after injury，and X-ray was used to evaluate whether distal tibiofibular syndesmosis diastasis.Results There was no statistical difference of Kofoed Scale and AOFAS Ankle Hindfoot Scale （P0.05） between two groups，and no patient had distal tibiofibular syndesmosis diastasis，but wood splint had better comfort and benefit early swelling.Conclusion The two kinds of external fixation combined with exercise therapy have good effect in treating distal tibiofibular syndesmosis injury.The external fixation of wood splint is more comfort，more beneficial for decreasing the swelling.It is good to popularize this therapy in clinical practice. [Key words]Distal tibiofibular syndesmosis injury；Wood splint；External fixation；Plaster 下?腓联合损伤是踝关节扭伤中较少发生的损伤，有研究表明其发生率为1%～18%[1]。其通常合并踝关节骨折，而单纯的下胫腓联合损伤较为少见，故此损伤在临床诊断中易被忽略而漏诊。同时，下胫腓联合损伤相比其他类型踝关节扭伤，其损伤修复时间更长，对于患者的运动水平影响更大[