[1]党丽君△,刘玉杰,高岩,等.踝关节骨折术后踝穴形态与踝关节功能的相关性研究[J].中国中医骨伤科杂志,2025,33(06):44-50.[doi:10.20085/j.cnki.issn1005-0205.250608]
　DANG Lijun,LIU Yujie,GAO Yan,et al.Study on the Correlation between Ankle Acupoint Morphology and Ankle Function after Ankle Fracture Surgery[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(06):44-50.[doi:10.20085/j.cnki.issn1005-0205.250608]
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踝关节骨折术后踝穴形态与踝关节功能的相关性研究()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年06期
页码:
44-50
栏目:
临床论著
出版日期:
2025-06-15

文章信息/Info

Title:
Study on the Correlation between Ankle Acupoint Morphology and Ankle Function after Ankle Fracture Surgery
文章编号:
1005-0205(2025)06-0044-07
作者:
党丽君1△; 刘玉杰1; 高岩1; 朱鹏飞1; 刘洪达1; 曲平艳1; 陈江华1
1唐山市第二医院(河北 唐山,063000)
Author(s):
DANG Lijun1△; LIU Yujie1; GAO Yan1; ZHU Pengfei1; LIU Hongda1; QU Pingyan1; CHEN Jianghua1
1The Second Hospital of Tangshan,Tangshan 063000,Hebei China.
关键词:
踝关节骨折;  踝穴形态;  踝关节功能;  影像学检查;  影响因素
Keywords:
ankle fractures;  morphology of ankle points;  ankle joint function;  imaging examination;  influencing factors
分类号:
R683.42
DOI:
10.20085/j.cnki.issn1005-0205.250608
文献标志码:
A
摘要:
目的:探讨踝关节骨折术后踝穴形态与踝关节功能的相关性,并分析影响踝关节功能的独立影响因素。方法:回顾性分析2022年1月至2023年1月进行手术治疗的243例踝关节骨折患者资料,男127例,女116例; 平均年龄为(44.61±12.33)岁。记录患者踝穴各项指标(踝穴宽度、踝穴高度、踝穴深度、冠状位水平角度、矢状位水平角度)患侧与健侧差值及术后复位情况和术前、术后即刻、3个月、12个月踝关节功能综合评分。Logistic 回归分析影响踝关节功能综合评分的独立影响因素。结果:末次随访时,与健侧比较,患侧的踝穴宽度为(27.62±1.34)mm,踝穴高度为(41.34±1.47)mm,踝穴深度为(38.84±1.24)mm,冠状位水平角度为6.48°±1.19°,矢状位水平角度为15.47°±1.48°,均明显增大,大于健侧(25.67±1.22)mm,(40.33±1.87)mm,(37.82±1.23)mm,5.44°±1.21°,13.23°±1.43°,差异有统计学意义(P<0.05); 各组患者踝穴各指标患侧与健侧差值比较显示,踝穴宽度差值、踝穴深度差值、冠状位水平角度差值、矢状位水平角度差值三组比较差异均有统计学意义(F=2.215～18.556,P<0.001)。末次随访踝关节复位情况分别为:优组复位差0例(0.00%),良组复位差3例(4.55%),可、差组复位差10例(18.52%)。三组踝关节复位情况比较差异有统计学意义(P<0.05); 三组治疗后随着时间的推移踝关节功能评分均有所改善。术后3个月及12个月优组踝关节功能评分为(88.47±7.28)分最高,良组为(77.41±9.34)分其次,可、差组(67.43±7.38)分最低,三组比较差异均有统计学意义(P<0.05)。多元有序Logistic 回归分析结果显示:年龄≥60岁、术后并发症、取出内固定物、未早期功能锻炼、伴有踝关节脱位、踝穴形态指标差(患侧与健侧踝穴宽度、踝穴深度、冠状位角度、矢状位角度差值)、Danis-Weber分型C型是导致踝关节骨折患者踝关节功能综合评分差的独立影响因素。结论:年龄>60岁、术后并发症、取出内固定物、未早期功能锻炼、伴有踝关节脱位、踝穴形态指标差(患侧与健侧踝穴宽度、踝穴深度、冠状位角度、矢状位角度差值)、Danis-Weber分型C型是导致踝关节骨折患者踝关节功能综合评分差的独立影响因素。因此,应重视早期诊断、合适的治疗方案和合适的康复训练,以达到更好的康复效果。
Abstract:
Objective:To explore the correlation between ankle acupoint morphology and ankle joint function after ankle fracture surgery,and to analyze the independent influencing factors affecting ankle joint function.Methods:The data of 243 patients with ankle fractures who underwent surgical treatment from January 2022 to January 2023 were retrospectively analyzed.There were 127 males and 116 females,with an average age of(44.61±12.33)years old.The difference between the affected side and the healthy side of the ankle points(the width of the ankle point,the height of the ankle point,the depth of the ankle point,the horizontal angle in the coronal position,and the horizontal angle in the sagittal position),the postoperative reduction,and the comprehensive score of ankle joint function before operation,immediately after operation,3 months after operation,and 12 months after operation were recorded.Logistic regression analysis was used to analyze the independent factors affecting the comprehensive score of ankle joint function.Results:At the last follow-up,compared with the healthy side,the ankle acupoint width(27.62±1.34)mm,ankle acupoint height(41.34±1.47)mm,ankle acupoint depth(38.84±1.24)mm,coronal horizontal angle 6.48°±1.19° and sagittal horizontal angle 15.47°±1.48° on the affected side were significantly larger than those on the healthy side(25.67±1.22)mm,(40.33±1.87)mm,(37.82±1.23)mm,5.44°±1.21°,13.23°±1.43°(P<0.05).The differences of ankle acupoint width,ankle acupoint depth,coronal horizontal angle and sagittal horizontal angle between the affected side and the healthy side in each group were statistically significant(F=2.21518.556,P<0.001).At the last follow-up,the ankle joint reduction was poor in 0 case(0.00%)of the excellent group,poor in 3 cases(4.55%)of the good group,and poor in 10 cases(18.52%)of the fair and poor group.There was statistically significant difference in ankle reduction among the three groups(P<0.05).Ankle functional scores improved over time after treatment in all three groups.At 3 months and 12 months after operation,the ankle function scores of the excellent group were the highest(88.47±7.28)points,the next good group(77.41±9.34)points,and the fair and poor group were the lowest(67.43±7.38)points.The differences among the three groups were statistically significant(P<0.05).Multivariate ordinal Logistic regression analysis showed that:age ≥60 years old,postoperative complications,removal of internal fixation,no early functional exercise,ankle dislocation,ankle acupoint morphological indexes(the width of ankle acupoint,the depth of ankle acupoint,the difference of coronal angle and sagittal angle between the affected and healthy sides)and Danis-Weber classification C were independent influencing factors for poor ankle joint function comprehensive score in patients with ankle fracture.Conclusion:Age>60 years,postoperative complications,removal of internal fixation,no early functional exercise,ankle dislocation,ankle acupoint morphological indexes(the width of ankle acupoint,the depth of ankle acupoint,the difference of coronal angle and sagittal angle between the affected and healthy sides)and Danis-Weber classification C were independent influencing factors for poor ankle joint function comprehensive score in patients with ankle fracture.Therefore,attention should be paid to early diagnosis,appropriate treatment and appropriate rehabilitation training to achieve better rehabilitation effects.

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更新日期/Last Update: 2025-06-15