| ObjectiveEarly clinical observation on the treatment of trimalleolus fracture by arthroscopy,it was explored clinical efficacy,safety and advantages comparing traditional open reduction and internal fixation.On this account,author provided a reference for the treatment of clinical path of ankle fracture.MethodsIn this study,30 patients enrolled were performed a control trial of same period,who suffered trimalleolar fracture between January and December 2017 in Guangdong Provincial Hospital of TCM.According to simple random methods,the author divided the patients into two groups: experimental group(medial malleolus and posterior malleolus treated with arthroscopy,lateral malleolus treated with traditional internal fixation)and control group(three malleolus treated with traditional internal fixation)were 15 cases respectively.The patients' basic information and data were collected.After admission,the AOFAS score,the VAS score,operation time,blood loss and length of incision was recorded.After 12 weeks follow-up,the AOFAS score and VAS score were recorded at 2 weeks and the AOFAS score,VAS score and X-ray film were recorded and performed the “san-huai scale” at 12 weeks.The description assessment and analytical statistics were performed with SPSS V20.0 and concluded.Results1.The age,gender and fractured limbs(left and right)of the two groups were compared before operation.There was no statistically significant difference between the two groups(P>0.05)by statistical analysis.2.The operation time,the length of incision and blood loss of the two groups were compared after operation.The experimental operation time(142.13±46.45 min)shorter than the control group(175.40±46.10 min)and there was no statistically significant difference in operation time between the two groups(P>0.05).Length of experimental group(11.58±0.98 cm)was shorter than that of the control group(15.83±1.61 cm)and it has statistically significant(P<0.05).Bleed loss of the experimental group(47.40±7.48 ml)was less than that of the control group(59.87±12.37 ml)with statistically significant(P<0.05).3.Experimental group and the control way within 2 weeks and 12 weeks postoperatively AOFAS score than preoperative enhancement,using analysis of variance of repeated measurement data,results indicate statistically significant difference(P<0.05).According to the results of multivariate anova,the AOFAS score had no significant difference betweenthe experimental group(33.73± 2.52)and the control group(34.80±2.57)before treatment(P>0.05).Comparison between groups in two weeks postoperatively,the experimental groupAOFAS score(85.33±3.79)is higher than control group(79.86±7.47)with statistically significant difference(P<0.05).The AOFAS scores after treatment in the two groups,theexperimental group was(93.26±3.86)higher than that of control group(89.26±4.77)in 12 weeks and it has statistically significant difference(P<0.05).At the end of the follow-up are calculated respectively in the two groups(12 weeks)and treatment before,theAOFAS score difference in experimental group(59.53±4.52)change is greater than the control group(54.46±6.01)and the difference has statistically significant(P<0.05).4.The VAS score of the experimental group and the control group was lower than the preoperative period in the second week and the 12 th week,and the variance analysis of the repeated measurement data was used.The results indicated that the difference was statistically significant(P< 0.05).According to the results of multivariate anova,the VAS score in experimental group(5.95±0.43)is lower than the control group(6.14±0.65)score,but had no significant difference between two groups before treatment(P>0.05).The VAS score in the second week after the operation in the experimental group(4.47±0.84)were lower than that of the control group(5.19±0.43)withstatistically significant difference(P<0.05).The VAS score in the 12 th week after the operation in the experimental group(2.56±0.64)were lower than that of the control group(2.78±0.59),but it had no statistical significance(P>0.05).Before and after the treatment(12 weeks)VAS score difference comparison between experimental group(3.39±0.68)and the control group(3.35±0.73),the difference with no statistically significant difference(P>0.05).5.The curative effect was evaluated after 12 weeks.Experimental group: excellent(12),good(3),fair(0),poor(0).Control group: excellent(5),good(10),fair(0),poor(0).The excellent rate of the experimental group(80%)was higher than that of the control group(33.34%),the difference was statistically significant(P<0.05).ConclusionThe early VAS score of the experimental group was lower than that of the control group,the AOFAS score was higher than that of the control group and the excellent rate was higher than that of the control group.It indicated that the early curative effect of arthroscopy-assisted internal fixation for the treatment on trimalleolar fracture was superior to traditional internal fixation.Besides,it can promote patients to early recovery and exercise and improved quality of life. |
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