| Objective:To compare the clinical efficacy of triangular ligament with repair or without repair to provide reference for the diagnosis and treatment of the injury.Methods:From July 2014 to July 2015,at Traditional Medical Traumatology Orthopedics of Wuxi,72 patients with ankle joint fractures together with triangular ligament injury were divided into repair group and non-repair group.All patients with ankle joint fractures were treated by open reduction and internal fixation treatment.In repair group,36 patients with triangular ligament injury were repaired,while36 patients in non-repair group were not.Postoperative follow-up was by telephone,or regular outpatient referral.The observation targets from the two groups include perioperative bleeding,operation time,AOFAS Ankle Hindfoot Scale,the incidence rate of postoperative complications,the length of hospitalization,posterior ankle joint pain score,and the width of the medial malleolus.The measurement data and counting data were showed by the mean ± standard deviation and ?2 test.The data of experimental results adoptingt test to calculate if P value under 0.05 representing the difference which showed statistical significant.Results:(1)The follow-up of 72 patients were with closed injury and no other parts of the fracture.Patients with ankle injury acquired for 3 to 7 days before doing surgery,an average of 4.3 days.The male patients in the repair group accounted for 56%,and 44%female patients.Among them,patients with left ankle injury accounted for 56%,and the right accounted for 44%.Male patients in another group accounted for 53%,and 47%of the female,for which patients with left ankle injury accounted 50%,and the right accounted 50%.The average age in repair group was 38.16 ± 13.55 years old,and that of the non-repair group was 38.68 ± 13.24 years old.(2)The sex,age,injury site,perioperative bleeding and the incidence rate of postoperative complications of the patients in the repair group were not statistically significant compared with the non-repair group.The operation time in repair group was 113.56 ± 14.68 min,while the non-repair group was 101.32 ± 13.96 min,by ?2 test getting the P value of 0.042 which less than 0.05,therefore,the operation time of the repair group was longer than that of the non-repair group.Three months after the surgery,the excellent rate of the ankle joint in the repair group was significantly higher than that in the non-repair group since the excellent rate was 91.7%in the repair group and 83.3%in the non-repair group.The hospitalization days in the repair group and the non-repair group were respectively 16.26 ± 3.62 days and 17.41 ± 4.02 days,by ?2 test getting the P value of 0.636 which greater than 0.05,therefore,There was no significant difference between the hospital stay in the experimental group and those in the control group.The pain index in ankle joint was respectively 1.06 ± 0.25 and 2.68 ± 0.32 in the repair group and non-repair group,which were obviously lower than those of 6.28 ± 0.82 and 6.20 ± 0.60 before operation.Meanwhile,compared with the non-repair group,the P value of the preoperative pain score in the repair was over than 0.05,and the postoperative P value was less than 0.05,which indicated that the effect of repairing the triangular ligament was better.In the repair group and the non-repair group,the width of the medial malleolus was respectively 2.06 ± 0.25 mm and 2.68 ± 0.32 mm,which were significantly lower than those of preoperative 5.12 ± 1.20 mm and 5.34 ±1.35 mm.The postoperative P value was less than 0.05,and the ankle gap in the repair group was smaller than that in the non-repair group.Conclusion:(1)By understanding patients' injuries history,carefully asking the clinical symptoms and examining the relevant physical sign,based on these above,taking imaging examination,can improve diagnostic accuracy.(2)Patients with ankle fracture associated with triangular ligament injury repairing triangular ligament can be a good way to shorten the recovery length,and is also important to recover patients' ankle function.(3)For patients with deep injury of the triangle ligament,writer of the paper suggests to choose surgical repair to restore the continuity and integrity of the triangular ligament. |
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