空心钉内固定与微型钢板内固定治疗后踝大块骨折的疗效比较

Comparison effect of internal fixation with cannulated screws and mini plate internal fixation for the treatment of posterior malleolus large fractures

目的比较空心钉内固定与微型钢板内固定治疗后踝大块骨折的临床疗效。方法将82例后踝大块骨折患者根据手术方法不同分为两组,行微型钢板内固定的41例患者纳入观察组,行空心钉内固定的41例患者纳入对照组。比较两组手术时间、术中出血量、骨折愈合时间、下床活动时间、踝关节恢复情况及并发症发生情况,按AOFAS踝-后足评分标准判定疗效。结果两组患者均获得随访,时间6～10(8. 13±1. 26)个月。两组手术时间和术中出血量比较差异无统计学意义(P> 0. 05);骨折愈合时间和下床活动时间观察组较对照组显著缩短(P <0. 01)。并发症发生率观察组为4. 88%,低于对照组的14. 65%(P <0. 05)。末次随访时疗效优良率观察组为85. 36%,高于对照组的73. 17%(P <0. 05)。结论后踝大块骨折患者采用微型钢板内固定较空心钉内固定效果好,可加速术后踝关节功能的恢复。

ObjectiveTo compare the clinical efficacy of internal fixation with cannulated screws and mini plate internal fixation in the treatment of posterior malleolus large fractures.MethodsThe 82 cases of posterior malleolus large fractures were divided into two groups according to different surgical methods:41 patients treated with mini plate internal fixation were included in the observation group,41 patients treated with cannulated screws internal fixation were in the control group.The operation time,blood loss,fracture healing time,out of bed activity time,and ankle joint restoration of two groups were observed,and the curative effect was judged according to the AOFAS ankle-hindfoot score criteria.ResultsBoth groups were followed up for 6~10(8.13±1.26)months.There was no significant difference in the operation time and intraoperative blood loss between the two groups(P>0.05).The fracture healing time and out of bed activity time of the observation group were significantly shorter than the control group(P<0.01).The complication incidence rate was 4.88%in the observation group and 14.65%in the control group(P<0.05).At the final follow-up,the excellent-good rate of treatment efficacy in the observation group(85.36%)was higher than that in the control group(73.17%),P<0.05.ConclusionsFor patients with posterior malleolus large fractures,the mini plate internal fixation is better than the cannulated screws internal fixation,which can accelerate the recovery of postoperative ankle joint function.