摘要目的:比较两种治疗踝关节骨折累及下胫腓联合伴三角韧带损伤方法的临床效果。方法:分析2019年1月至2022年11月期间唐山市第二医院医院Weber B、C型踝关节骨折累及下胫腓联合伴三角韧带损伤患者的资料，患者按照性别、年龄、受伤原因、受伤部位组间具有可比性的原则分为观察组（45例）和对照组（39例），分别采用带袢钢板治疗下胫腓联合及三角韧带损伤，与带袢钢板治疗下胫腓联合损伤三角韧带带线锚钉全层修复的方法治疗。记录并比较两组患者骨折愈合时间、手术时间、手术费用、美国踝-后足评分（American orthopedic foot and ankle society，AOFAS）评分、视觉模拟量表（visual analogue scale，VAS）评分、下胫腓关节间隙（tibiofibular clear space，TFCS）、内侧关节间隙（medial clear space，MCS）等。结果:观察组骨折愈合时间（4.36±1.26）个月，对照组骨折愈合时间（4.08±1.35）个月，两组比较差异无统计学意义（ t=0.978， P=0.331）。观察组手术时间（85.72±14.54）min，对照组手术时间（109.76±14.02）min；观察组手术费用（37 048±2 299.53）元，对照组手术费用（39 040.22±2 306.02）；两组差异均有统计学意义（ t值分别为7.71、3.95，均 P<0.001）。观察组AOFAS评分（81.18±3.77）分，对照组AOFAS评分（81.26±3.91）分；观察组VAS评分（0.90±0.38）分，对照组VAS评分（0.87±0.39）分，两组比较差异均无统计学意义（ t=0.09， P=0.926； t=0.39 ，P=0.698）。观察组MCS（3.46±0.25）mm，对照组MCS（3.53±0.26）mm；观察组TFCS（3.49±0.24）mm，对照组TFCS（3.47±0.26）mm。两组比较差异均无统计学意义（ t=1.24 ，P=0.217 ；t=0.21， P=0.833）。 结论:虽然踝关节骨折累及下胫腓联合伴三角韧带损伤的患者只行带袢钢板或带袢钢板联合带线锚钉修复治疗均可获得满意的临床效果，但只应用带袢钢板可减少患者治疗费用，降低手术难度，减轻患者医源性损伤风险。

abstractsObjective:To compare the clinical effects of two methods for the treatment of ankle fracture involving lower tibiofibular syndesmosis with triangular ligament injury.Methods:From January 2019 to November 2022, the data of patients with Weber B and C-type ankle fractures involving lower tibiofibular syndesmosis with triangular ligament injury in Tangshan Second Hospital were analyzed. The patients were divided into observation group (45 cases) and control group (39 cases) according to the principle of comparability between the groups of gender, age, injury cause and injury site, Both the treatment of lower tibiofibular syndesmosis and triangular ligament injury with loop steel plate and the treatment of lower tibiofibular syndesmosis injury with loop steel plate, as well as the full layer repair of triangular ligament with wire anchor nail, were used for treatment. Record and compare the fracture healing time, surgical time, surgical cost, American Orthopedic Foot and Ankle Society (AOFAS) score, Visual Analogue Scale (VAS) score, Tibiofibular Clear Space (TFCS) score Medial clear space (MCS), etc.Results:The fracture healing time in the observation group was (4.36±1.26) months, while the fracture healing time in the control group was (4.08±1.35) months. There was no statistically significant difference between the two groups (t=0.978, P=0.331). The observation group had a surgical time of (85.72±14.54) minutes, while the control group had a surgical time of (109.76±14.02); Observation group surgery cost (37 048±2 299.53) Font: ( t=0.978 p=0.331) Delete ( t=7.706 p<0.001) Delete: yuan, control group surgery cost (39 040.22±2 306.02); The differences between the two groups were statistically significant (t-values were 7.71 and 3.95, respectively, P<0.001). The AOFAS score of the observation group was (81.18±3.77) points, while the AOFAS score of the control group was (81.26±3.91) points; The VAS score of the observation group was 0.90±0.38 points, while the VAS score of the control group was 0.87±0.39 points. There was no statistically significant difference between the two groups ( t=0.09, P=0.926; t=0.39, P=0.698). The observation group had a MCS of (3.46±0.25) mm, while the control group had a MCS of (3.53±0.26) mm; The observation group had TFCS (3.49±0.24) mm, while the control group had TFCS (3.47±0.26) mm. There was no statistically significant difference between the two groups ( t=1.24, P=0.217; t=0.21, P=0.833). Conclusions:Although the patients with ankle fracture involving lower tibiofibular syndesmosis and triangular ligament injury can obtain satisfactory clinical results only by using the looped steel plate or the looped steel plate combined with the cable anchor, the application of the looped steel plate alone can reduce the treatment cost of patients, reduce the difficulty of surgery, and reduce the risk of iatrogenic injury of patients.