微型钢板与空心钉内固定治疗后踝大块骨折患者术后关节功能恢复效果的比较  

Effect of internal fixation with mini plate and cannulated screw on postoperative recovery of joint function in patients with large fracture of posterior malleolus

作　　者：范军界 虞宵 吕峰 吴卫东 沈军[2] 孙立 FAN Junjie;YU Xiao;LV Feng;WU Weidong;SHEN Jun;SUN Li(Department of Orthopedics,Suzhou Ninth Hospital Affiliated to Suzhou University,Suzhou 215000,China)

机构地区：[1]苏州大学附属苏州九院骨科,江苏苏州215000 [2]南京医科大学附属苏州医院骨科,江苏苏州215000

出　　处：《实用医学杂志》2024年第18期2571-2577,共7页The Journal of Practical Medicine

基　　金：江苏省科技项目(编号:BE2021659);南京医科大学姑苏学院青年骨干科学研究培育专项项目(编号:GSKY20220521)。

摘　　要：目的比较后踝大块骨折患者采用微型钢板与空心钉内固定治疗对术后关节功能恢复的影响。方法选择自2021年3月至2023年6月来我院进行治疗的后踝大块骨折患者150例,采用奇偶数法进行分组,其中75例进行空心钉内固定治疗的患者列为对照组,另外75例实施微型钢板内固定治疗的患者纳入观察组。对比分析两组患者的临床指标、踝关节活动度、踝关节功能以及健康状态,统计炎症因子水平、术后并发症以及临床疗效。结果在手术时间与术中出血量上,两组对比差异无统计学意义(P>0.05);在下床活动时间、骨折愈合时间以及住院时间上,观察组短于对照组(P<0.05)。踝关节背伸、踝关节跖屈、足部内翻以及足部外翻活动度上,观察组明显优于对照组(P<0.05)。在AOFAS评分与KPS评分上,观察组高于对照组(P<0.05)。在IL-6、IL-8以及CRP水平上,观察组低于对照组(P<0.05)。在术后并发症发生率上,观察组低于对照组(P<0.05)。结论微型钢板内固定术用于后踝大块骨折的手术效果理想,对于临床指标与踝关节活动度的改善具有促进作用,可有效提升踝关节功能,减轻炎症反应,减少术后并发症,临床可进一步推广运用。Objective To analyze the impact of mini plate and cannulated screw internal fixation on joint function recovery in patients with posterior malleolus fracture.Methods A total of 150 patients with posterior malleolus fractures,treated at our hospital from March 2021 to June 2023,were included in this study.They were divided into two groups using the odd-even number method.The control group consisted of 75 patients who underwent cannulated screw internal fixation,while the study group comprised 75 patients who received mini plate internal fixation.Clinical indicators,ankle range of motion,ankle function,and health status were compared and analyzed between the two groups.Additionally,levels of inflammatory factors,postoperative complications,and clinical efficacy were assessed.Results In terms of operation time and intraoperative blood loss,there was no statistically significant difference between the two groups(P>0.05).However,the study group exhibited shorter ambulation days,fracture healing time,and hospitalization days compared to the control group(P<0.05).Moreover,the study group demonstrated significantly improved ankle dorsiflexion,ankle plantar flexion,foot varus and foot valgus range of motion compared to the control group(P<0.05).Additionally,higher AOFAS score and KPS score were observed in the study group as compared to the control group(P<0.05).Furthermore,levels of IL-6,IL-8 and CRP were lower in the study group than in the control group(P<0.05).The incidence of postoperative complica⁃tions was also lower in the study group than in the control group(P<0.05).Conclusion Mini plate internal fixa⁃tion for posterior malleolus fracture yields ideal outcomes by promoting improvement in clinical indicators and ankle range of motion while effectively enhancing ankle function,reducing inflammatory reaction as well as minimizing postoperative complications.

关 键 词：后踝大块骨折 微型钢板内固定术 空心钉内固定术 关节功能 

分 类 号：R683[医药卫生—骨科学]