锁定钢板联合拉力螺钉内固定术与非锁定钢板内固定术对踝关节骨折合并下胫腓分离患者预后的影响  

Effect of locking plate combined with lag screw internal fixation and non-locking plate internal fixation on prognosis in patients with ankle fractures and lower tibiofibular separation

作　　者：沙川 马超 那键 SHA Chuan;MA Chao;NA Jian(Department of Orthopaedics,1.The Affiliated Pizhou Hospital of Xuzhou Medical University,Xuzhou 221300;The Affiliated Xuzhou Clinical College of Xuzhou Medical University,Xuzhou 221000,Jiangsu,China)

机构地区：[1]徐州医科大学附属邳州医院骨科,江苏徐州221300 [2]徐州医科大学徐州临床学院骨科,江苏徐州221000

出　　处：《川北医学院学报》2024年第4期511-515,共5页Journal of North Sichuan Medical College

基　　金：江苏省徐州市科技计划项目(ZYSH20230252)。

摘　　要：目的:探究锁定钢板结合拉力螺钉内固定术对踝关节骨折合并下胫腓分离患者预后的影响。方法:回顾性分析176例踝关节骨折合并下胫腓分离患者的临床资料。将176例患者按术式不同分为对照组(n=74)与观察组(n=102),比较两组患者手术相关指标、炎症因子水平、骨代谢情况、关节功能及并发症发生情况。结果:观察组患者手术、住院及骨折愈合时间均短于对照组(P<0.05);术后3 d及1周,观察组白细胞介素6、白细胞介素8、去甲肾上腺素、C反应蛋白水平均低于对照组(P<0.05);术后3、6个月,观察组患者骨碱性磷酸酶、血清骨钙素均高于对照组(P<0.05),β-胶原降解产物低于对照组(P<0.05);术后6个月,观察组关节功能各维度得分均高于对照组(P<0.05),并发症发生率低于对照组(P<0.05)。结论:对于踝关节骨折并伴有下胫腓分离患者而言,锁定钢板与拉力螺钉内固定术结合使用,更能降低炎症因子水平,增强骨代谢能力,提升关节功能,减少并发症的发生几率,有利于促进恢复和改善预后,具有临床应用价值。Objective:To explore the effect of locking plate combined with lag screw internal fixation on the prognosis in patients with ankle fractures complicated with lower tibiofibular separation.Methods:The clinical data of 176 patients with ankle fractures complicated with lower tibiofibular separation were retrospectively collected.According to locking plate combined with lag screw internal fixation and non-locking plate internal fixation,176 patients were divided into control group(n=74)and observation group(n=102).The surgical related indicators,levels of inflammatory factors,bone metabolism status,joint function and complications of the two groups were compared.Results:The surgical time,hospital stay and fracture healing time of patients in observation group were shorter compared with those in control group(P<0.05).The observation group had lower levels of interleukin-6,interleukin-8,norepinephrine and C-reactive protein at 1 week after surgery(P<0.05).At 3 and 6 months after surgery,the levels of bone alkaline phosphatase and serum osteocalcin in the observation group were higher than those in the control group(P<0.05),while the level ofβ-collagen degradation product were lower than those in the control group(P<0.05).The scores of dimensions of joint function at 6 months after surgery in observation group were higher compared to control group(P<0.05).The incidence rates of complications were lower in observation group in comparison with those in control group(P<0.05).Conclusion:For patients with ankle fractures and lower tibiofibular separation,locking plate combined with lag screw internal fixation can reduce the inflammatory factors levels,enhance the bone metabolism ability,improve the joint function,reduce the incidence rates of complications,and help to promote the recovery and improve the prognosis,with clinical application value.

关 键 词：锁定钢板联合拉力螺钉内固定术 非锁定钢板内固定术 踝关节骨折合并下胫腓分离 预后 

分 类 号：R683[医药卫生—骨科学]