Objective:To explore the changes in ankle mortise morphology and the influencing factors of ankle joint function after open reduction and internal fixation surgery for ankle joint fractures.Methods:The patients with ankle fractures and accepted open reduction and internal fixation in the orthopedics d epartment of Nantong Hospital Affiliated to Shanghai University from January 2018 to June 2021 were selected and divided into the excellent group, the good group, and the fair to poor group based on the American Foot and Ankle Association ankle and posterior foot function score (AOFAS). Multiple factor linear regression analysis was used to analyse the relationship between AOFAS score and morphological indices of ankle joint( including the width, depth, coronal and sagittal angles).Results:A total of 98 patients were enrolled. Changes in ankle morphology: (1) compared with the healthy side, the width, depth, and coronal and sagittal angles of the ankle on the affected side of patients with ankle fracture after open reduction and internal fixation were significantly increased(t=6.835, 3.523, 6.105, 10.670, all P<0.05). (2)AOFAS score of ankle joint function in patients with ankle fracture after open reduction and internal fixation surgery was (77±9). The differences in ankle shape indices between the healthy and sick sides of the three groups were statistically significant (F=396.749, 136.520, 59.694, 406.548, all P< 0.05). (3) The difference in morphological indices of ankle joint between the healthy and sick sides of postoperative patients was significantly negatively correlated with the AOFAS score of ankle joint function (r=-0.368, -0.398, -0.208, -0.423, all P< 0.05). Factors influencing ankle joint function: (1) comparison of AOFAS for different ages, start of rehabilitation, and adherence to functional training showed statistically significant differences (t=2.460, 3.549, both P<0.05). (2) Age[B=0.386, 95%CI(0.207, 0.565), P<0.001], adherence to functional training[B=-9.623, 95%CI(-15.118, -4.129), P=0.001], and the differences in ankle width between the affected and healthy sides [B=-1.200, 95%CI(-1.785, -0.614), P<0.001] were the main influencing factors on postoperative AOFAS scores of ankle joint function.Conclusion:There is a significant negative correlation between the changes in ankle morphology and ankle joint function in patients after open reduction and internal fixation for ankle joint fractures.

目的 分析PFNA髓内钉远端螺钉交锁方式对31-A2型老年股骨近端骨折的疗效影响.方法 将2018年1月-2021年1月收治的98例股骨转子间骨折患者纳入研究对象,患者均采取PFNA髓内钉固定,根据远端螺钉锁定方式分为静力组和动力组,每组49例,对两组患者总体治疗效果、生活质量评分、并发症发生率及治疗前后髋关节功能评分、疼痛评分进行对比分析,生存质量指标包括心理领域、环境领域、生理领域、社会领域.结果 静力组中总有效率为95.92％,动力组中总有效率为93.88％,静力组治疗显效率和总有效率与动力组比较差异无统计学意义(P>0.05),不良反应发生率比较差异无统计学意义(P>0.05),且静力组患者在心理领域、环境领域、生理领域、社会领域评分比较差异无统计学意义(P>0.05);治疗前两组患者髋关节功能评分、疼痛评分水平比较无明显差异(P>0.05),治疗后均明显改善(P<0.05),组间比较差异无统计学意义(P>0.05).结论 PFNA髓内钉远端螺钉交锁方式对31-A2型老年股骨近端骨折具有良好的临床疗效影响.

目的:探究对GustiloⅢ型胫腓骨开放性骨折联用外固定架与封闭负压引流术(VSD)技术的可行性;方法:选择2018年1月至2020年12月于我院接受治疗的84例GustiloⅢ型胫腓骨开放性骨折患者,将其按照双盲、对照、随机的原则均分为两组,每组各42例,对照组接受常规髓内钉治疗,研究组接受外固定架与VSD技术,对比两组愈合情况以及各类并发症发生率的差异;结果:研究组治疗总有效率97.62％,明显高于对照组的83.33％(P<0.05);研究组患者手术时间、下床时间及骨折愈合时间均低于对照组(P<0.05);研究组并发症总发生率4.76％,明显低于对照组的19.04％(P<0.05);结论:GustiloⅢ型胫腓骨开放性骨折行外固定联合VSD技术临床疗效较好,能够显著加快患者术后康复,并降低各类并发症发生率.