弹簧钩钢板在踝关节骨折及粉碎性踝关节后方结构损伤内固定中的应用  

Application of spring hook plate in internal fixation of ankle fracture and comminuted posterior structural injury of ankle

作　　者：徐子彧[1] 刘俊鹏 黎萌 XU Zi-yu;LIU Jun-peng;LI Meng(Department of Orthopedics,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院骨科,北京100020

出　　处：《临床和实验医学杂志》2025年第6期648-651,共4页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金项目(编号:81071515)。

摘　　要：目的探讨弹簧钩钢板在踝关节骨折及粉碎性踝关节后方结构损伤内固定中的应用效果。方法回顾性选取2022年5月至2024年5月到首都医科大学附属北京朝阳医院就诊的98例踝关节骨折患者作为研究对象。按照内固定方式不同进行分组:观察组(n=49)和对照组(n=49)。观察组患者应用弹簧钩钢板进行内固定;对照组患者应用空心螺钉进行内固定。比较两组患者的手术情况(手术时间、术中出血量、术后引流量、住院时间、骨折愈合时间),术前和术后3个月的骨代谢指标[Ⅰ型前胶原氨基端前肽(PINP)、骨形态发生蛋白2(BMP2)、转化生长因子β1(TGF-β1)]水平,术后6个月的踝关节功能,出院时、术后1、2、3个月的骨痂评分,术后6个月并发症发生情况,以及出院时和术后6个月的生活质量[生活质量综合评定问卷-74(GQOLI-74)评分]。结果两组患者的手术时间、术中出血量比较,差异均无统计学意义(P>0.05);观察组患者的术后引流量为(49.27±7.55)mL,明显少于对照组[(53.86±6.49)mL],观察组住院时间及骨折愈合时间分别为(11.82±2.06)、(109.25±15.67)d,均明显短于对照组[(13.13±2.41)、(120.33±17.26)d],差异均有统计学意义(P<0.05)。术后3个月,两组患者的PINP、BMP2、TGFB1水平均较术前明显增高,且观察组的PINP、BMP2、TGFB1水平分别为(30.63±6.14)μg/mL、(91.13±13.65)ng/L、(420.35±42.48)μg/L,均明显高于对照组[(27.24±5.82)μg/mL、(84.74±11.54)ng/L、(398.33±51.54)μg/L],差异均有统计学意义(P<0.05)。术后6个月,观察组患者的优良率为93.88%,明显高于对照组(79.59%),差异有统计学意义(P<0.05)。出院时,两组患者的骨痂评分比较,差异无统计学意义(P>0.05);术后1、2、3个月,观察组患者的骨痂评分分别为(1.42±0.26)、(2.06±0.51)、(2.64±0.57)分,均明显高于对照组[(1.26±0.41)、(1.74±0.43)、(2.25±0.61)分],差异均有统计学意义(P<0.05)。术后6个月,观察组患�Objective To investigate the effect of spring hook plate in the internal fixation of ankle fracture and comminted posterior structure injury of ankle joint.Methods A retrospective study was conducted on 98 patients with ankle fractures who were admitted to Beijing Chaoyang Hospital,Capital Medical University from May 2022 to May 2024.They were divided into the observation group(n=49)and the control group(n=49)according to the different internal fixation methods.The observation group was subjected to internal fixation with spring hook plate,and the control group was subjected to internal fixation with hollow screws.The operation conditions(operation time,intraoperative blood loss,postoperative drainage volume,hospitalization time,fracture healing time),bone metabolism indexes[type I procollagen amino terminal propeptide(PINP),bone morphogenetic protein 2(BMP2),transforming growth factor β1(TGF-β1)]levels before operation and 3 months after operation,ankle joint function,callus score at discharge and 1,2,3 months after operation,complications at 6 months after operation and quality of life[generic quality of life inventory-74(GQOLI-74)score]at discharge and 6 months after operation were compared between the two groups.Results There were no statistically significant differences in operation time and intraoperative blood loss between the two groups(P>0.05).The postoperative drainage volume of the observation group was(49.27±7.55)mL,which was significantly less than that of the control group[(53.86±6.49)mL],the hospitalization time and fracture healing time were(11.82±2.06)and(109.25±15.67)d,which were significantly shorter than those of the control group[(13.13±2.41)and(120.33±17.26)d],and the differences were statistically significant(P<0.05).At 3 months after operation,the levels of PINP,BMP2 and TGF-β1 in the two groups were significantly higher than those before operation,and the levels of PINP,BMP2 and TGF-β1 in the observation group were(30.63±6.14)μg/mL,(91.13±13.65)ng/L and(420.35±42.48)μg/L,re

关 键 词：踝关节骨折 粉碎性踝关节后方结构损伤 弹簧钩钢板 内固定 

分 类 号：R687.3[医药卫生—骨科学]