锁定加压钢板内固定联合胫前减张切口治疗老年胫腓骨远端骨折的效果

Effect of locking compression plate internal fixation combined with pretibial decompression incision in the treatment of distal tibiofibular fracture in the elderly

目的探讨锁定加压钢板内固定联合胫前减张切口治疗老年胫腓骨远端骨折的效果。方法选定本院于2015年11月12日至2018年7月6日收诊的50例老年胫腓骨远端骨折患者,采用随机法将其分为观察组(25例,锁定加压钢板内固定+胫前减张切口)与对照组(25例,锁定加压钢板内固定)。比较两组的踝关节功能优良率、术中出血量、骨折愈合时间、住院时间、膝关节最大活动度及并发症发生情况。结果观察组踝关节功能优良率高于对照组,差异具有统计学意义(P<0.05)。观察组术中出血量少于对照组,骨折愈合时间、住院时间均短于对照组,差异具有统计学意义(P<0.05)。治疗前,两组患者膝关节后伸最大活动度和膝关节前屈最大活动度比较,差异无统计学意义(P>0.05);治疗后,两组膝关节后伸最大活动度和膝关节前屈最大活动度均升高,且观察组高于对照组,差异具有统计学意义(P<0.05)。观察组并发症总发生率显著低于对照组,差异具有统计学意义(P<0.05)。结论锁定加压钢板内固定联合胫前减张切口方法可有效减少老年胫腓骨远端骨折患者的并发症发生率,改善其踝关节功能,值得临床推广使用。

Objective To investigate the effect of locking compression plate internal fixation combined with pretibial decompression incision in the treatment of distal tibiofibular fracture in the elderly.Methods Fifty elderly patients with distal tibiofibular fracture who were admitted in our hospital from November 12,2015 to July 6,2018 were selected and randomly divided into observation group(25 cases,locking compression plate internal fixation+pretibial decompression incision)and control group(25 cases,locking compression plate internal fixation).The excellent and good rates of ankle joint function,the amount of intraoperative blood loss,fracture healing time,hospitalization time,maximum knee joint activity and complications were compared between the two groups.Results The excellent and good rate of ankle joint function in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).The amount of intraoperative blood loss in the observation group was less than that in the control group,and the time of fracture healing and hospitalization were shorter than those in the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the maximum activity of knee joint extension and flexion between the two groups(P>0.05);after treatment,the maximum activity of knee joint extension and flexion in both groups increased,and those of the observation group were higher than the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Locking compression plate internal fixation combined with pretibial decompression incision can effectively reduce the incidence of complications and improve the ankle joint function in elderly patients with distal tibiofibular fractures,which is worthy of clinical popularization and application.