关键词: 外踝, 粉碎骨折, 复位质量, Nice结法, 并发症

Abstract: Objective  To investigate the effect of preoperative imaging combined with intraoperative Nice knot technique in the treatment of comminuted fractures of the lateral ankle.Methods  A total of 123 patients with comminuted fractures of the lateral ankle were admitted to our hospital from June 2021 to July 2023.62 patients who underwent routine reduction techniques were included in the control group,and 61 patients who underwent preoperative imaging combined with intraoperative Nice knot reduction were included in the observation group.The surgical indicators of surgery,intraoperative reduction quality and complication rate were compared between the two groups,as well as range of motion of talus calf angle and ankle joint before and 1 year after surgery,the affected and healthy sides of the talus calf angle,ankle joint range of motion,and functional prognosis at 1 year after surgery.Results The operation time in the observation group was (62.10±17.58) minutes,which was shorter than that in the control group (78.45±20.29) minutes.The intraoperative reduction time was (29.59±8.45) minutes,which was shorter than that in the control group (35.74±10.28) minutes.The length of the lateral malleolus incision was (10.02±2.88) cm,which was shorter than that in the control group (15.11±3.67) cm.The incision healing time was (11.30±2.16) days,which was shorter than that in the control group (14.88±2.48) days.The hospitalization time was (12.30±2.48) days,which was shorter than that in the control group (15.99±2.57) days.The intraoperative blood loss was (38.74±12.08) ml,which was lower than that in the control group (65.86±17.11) ml.The satisfaction rate of reduction was 95.08%,which was higher than that in the control group's 77.42% (P<0.05).One year after surgery,the talus-leg angle,ankle dorsiflexion,and ankle plantar flexion in the observation group were higher than those in the control group,while the talus-leg angle,ankle dorsiflexion,and ankle plantar flexion on the affected side in the control group were lower than those on the healthy side (P<0.05).The excellent and good rate of functional prognosis in the observation group was 95.08%,which was higher than that in the control group's77.42% (P<0.05).There was no significant difference in the total incidence of complications between the two groups (P＞0.05).Conclusion Preoperative imaging combined with intraoperative Nice knot technique can optimize the surgical process for patients with comminuted fractures of the lateral ankles,reduce tissue damage,promote perioperative recovery,and improve the reduction effect.

Key words: lateral ankle, comminuted fractures, reset quality, Nice knot technique, complication