| Objective: By comparing the similarities and differences of the clinical effects of surgical treatment,local injection of autologous PRP and plaster fixation on the repair of acute anterior talofibular ligament(ATFL)injury of the ankle joint,it is the choice of clinical treatment plan for acute anterior talofibular ligament injury for reference.Methods: A study was used to analyze the data of 96 patients with acute anterior talofibular ligament injury admitted to the Da Lian medical university Hospital from August 2017 to June 2020.Divided into three groups.Group A underwent small incision and anatomical repair of the anterior talofibular ligament.A total of 33 patients(19 males and 14 females),aged 30.36±6.46(18-41)years old,and visiting time were 42.25±56.41(2-264)hours,1ATFL injury classification(10 cases of type IIB,23 cases of type III).Group B received autologous Platelet-Rich Plasma(PRP)local injection and plaster external fixation treatment.A total of 33 patients(18 males and 15 females),aged28.84±5.67(17-40)years old,came to the clinic The visit time was 30.09±43.89(3-168)hours,and the ATFL injury classification(15 cases of type IIB,18 cases of type III).Group C underwent ankle plaster fixation treatment group,a total of 30 cases(17 males,13females),age 31.45±7.27(16-47)years old,visit time 58.24±83.23(2-360)hours,ATFL injury classification(10 cases of type IIB,20 cases of type III).Regular follow-up after treatment to observe the pain,range of motion,stability,walking gait and movement status of the affected ankle joint.By comparing the three groups before treatment,1 month,4 months,and 6 months after treatment,when walking normally Pain Visual Analog Scale(VAS),American Orthopedic Foot and Ankle Score(AOFAS),Karlsson Scoring Scale(Karlsson Scoring Scale),and distance of talus forward.Evaluation of clinical efficacy of each treatment method.Results: 1.General data of the three groups of patients,such as age,gender,body mass index(BMI),visit time,type and method of injury,etc.It was no statistically significant difference.All patients were followed up with an average of 9.95±2.03(7-15)months.2.Comparison of the three groups of patients:(1)Group A :AOFAS score,VAS score,Karlsson score changed from 63.45±5.37),(3.87±1.19),(54.70±6.63)before surgery to at the last follow-up(93.79±3.05),(0.93±0.62),(92.03±3.43),the divergence was statistically significant(t=-28.22,p=0.00,P<0.05;t=11.15,p=0.00,P<0.05;t=-29.69,p=0.00,P<0.05)(2)Group B :AOFAS score,VAS score,Karlsson score changed from preoperative(63.12±6.36),(3.34±0.93),(56.30±7.29)to(90.39±3.47),(0.78±0.61),(91.30±3.35)at the last follow-up,the difference is statistically significant(t=-21.79,p=0.00;t=12.65,p=0.00;t=-25.06,p=0.00,P<0.05);(3)Group C: AOFAS score,VAS score,Karlsson score changed from preoperative(65.80±6.84),(3.74±0.95),(55.45±6.84)to(88.43±3.58),(1.55±0.89),(87.64±4.01),at the last follow-up,,the difference is statistically significant(t=-16.06,p=0.00,P<0.05;t=9.42,p=0.00,P<0.05;t=-22.61,p=0.00,P<0.05)。3.Comparison of the three groups of patients:(1)There was no significant diversity in the AOFAS score,VAS score,and Karlsson score of the three groups before surgery(p<0.05).Six months after operation,there were divergence in AOFAS scores,VAS scores,and Karlsson scores between groups A,C,B,and C compared with preoperative scores(P<0.05);there were divergence in AOFAS scores between groups A and B.It is statistically significant,and there is no difference in Karlsson score and VAS score.(2)There were differences in the excellent and good rate of AOFAS scores in the three groups after operation,and the differences were statistically significant(p<0.05).Group A has a higher AOFAS score excellent rate than Group B and C.(3)There were divergence in the distance of talus advancement among the three groups at 6 months later,and the divergence was statistically significant(F=57.54,p<0.05).Compared with groups B and C,the anterior distance of the talus in group A was significantly decreased(p<0.05).After surgical treatment,the patient’s pain was significantly reduced,and the ankle joint function was significantly improved.4.After treatment,most of the patients had obvious relief of ankle pain and good activity.The anterior drawer test and the stress inversion test were negative.The 6-month followup showed that the incision healed well in group A,and there were no serious complications such as skin numbness around the incision and no incision infection.In group B,there was 1 case of secondary operation and 2 cases of long-term pain.In group C,there were 2 cases of limited ankle motion and 2 cases of ankle joint pain.Conclusions: Compared with autologous platelet-rich plasma injection and plaster fixation,surgical treatment of acute anterior talofibular ligament injury has a better curative effect in the short term.The patient’s postoperative functional recovery is obvious,with less pain,and avoiding the reduction of quality of life. |
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