可吸收钉板与金属钉板治疗Cotton骨折的疗效对比

Comparison of the efficacy of Cotton fractures using absorbable versus metal plate and screw

目的比较可吸收钉板与金属钉板治疗Cotton骨折的临床疗效。方法手术治疗62例Cotton骨折患者,应用可吸收钉板固定28例（A组）,金属钉板固定34例（B组）。记录两组患者住院时间、住院费用、负重时间、骨折愈合时间、并发症情况;术后6个月采用Baird-Jackson评定标准评价踝关节功能。结果 62例均获随访,时间13-25个月。住院时间：A组为（12.27±2.38）d,B组为（13.45±1.25）d;住院费用：A组为（4.05±0.11）万元,B组为（4.35±0.16）万元;手术时间：A组为（2.41±0.41）h,B组为（2.52±0.37）h;负重时间：A组为（2.98±0.52）个月,B组为（3.06±0.43）个月;骨折愈合时间：A组为（5.71±1.01）个月,B组为（5.81±1.08）个月;两组以上各项比较差异均无统计学意义（P〉0.05）。两组均无内固定失效及螺钉松动、断裂等并发症发生。术后6个月按Baird-Jackson评定标准评价踝关节功能：A组优16例,良9例,可2例,差1例,优良率为89.29%;B组优19例,良11例,可3例,差1例,优良率为88.24%;两组比较差异无统计学意义（P〉0.05）。结论可吸收钉板内固定能有效治疗Cotton骨折,优良率与金属钉板固定相似,且无需二次手术取出,可有效减少感染率。

Objective To compare the clinical efficacy of absorbable plate and screws for the treatment of Cotton fractures with metallic plate and screws. Methods 62 patients with Cotton fractures were treated by operation; absorbable plate and screws fixation was used in 28 cases（ group A） and metallic plate and screws fixation was used in 34cases（ group B）. The hospitalization time and hospitalization costs,fracture healing time,weight bearing time,and complications were recorded. According to Baird-Jackson scoring system,the function of the ankle was assessed in 6months postoperation. Results 62 cases were followed up for 13 - 25 months. The hospitalization time was（ 12. 27± 2. 38） d in group A and（ 13. 45 ± 1. 25） d in group B; The hospitalization costs was（ 4. 05 ± 0. 11） million yuan in group A and（ 4. 35 ± 0. 16） million yuan in group B; The operative time was（ 2. 41 ± 0. 41） h in group A and（ 2. 52 ± 0. 37） h in group B; The weight bearing time was（ 2. 98 ± 0. 52） months in group A and（ 3. 06 ± 0. 43）months in group B; The fracture healing time was（ 5. 71 ± 1. 01） months in group A and（ 5. 81 ± 1. 08） months in group B; There was not statistically significant in all of above projects（ P〉0. 05）. No fixation failure,breakage,or loosening occurred in 2 groups. According to Baird-Jackson scoring system： the results were excellent in 16 cases,good in 9,fair in 2 and poor in 1,with an excellent and good rate of 89. 29% in group A in 6 months postoperation;the results were excellent in 19 cases,good in 11,fair in 3 and poor in 1,with an excellent and good rate of 88. 24%in group B; No significant difference was found between 2 groups（ P〉0. 05）. Conclusions Treatment of Cotton fracture with absorbable plate and screws can get good effectiveness,and have an excellent-good rate similar to metal plate and screws,and avoid additional operation for removing the screw,and are effective in reducing infection rates.