胫前减张切口联合锁定加压钢板内固定治疗老年胫腓骨骨折的效果

Effect of anterior tibial tibial incision combined with locking compression plate internal fixation on elderly patients with tibiofibular fractures

目的分析胫前减张切口联合锁定加压钢板内固定治疗老年胫腓骨骨折的效果。方法采用随机数字表法将70例老年胫腓骨骨折患者分为观察组(n=35,胫前减张切口联合锁定加压钢板内固定术)与对照组(n=35,常规锁定加压钢板内固定术)。比较两组的治疗效果。结果观察组的消肿治疗时间和住院时间短于对照组,术后引流量少于对照组(P<0.05)。术后6个月,两组AOFAS踝关节功能评分均较术前升高,且观察组高于对照组(P<0.05)。术后3 d,两组血清MDA水平均高于术前,SOD水平均低于术前,且观察组优于对照组(P<0.05);术后7 d,两组血清MDA水平均低于术前,SOD水平均高于术前(P<0.05),但组间比较,差异不显著(P>0.05)。观察组术后1个月手术切口愈合情况优于对照组(P<0.05)。结论胫前减张切口联合锁定加压钢板内固定治疗老年胫腓骨骨折,有助于恢复踝关节功能,减轻氧化应激反应,促进手术切口愈合。

Objective To analyze the effect of anterior tibial tibial incision combined with locking compression plate internal fixation on elderly patients with tibiofibular fractures.Methods Seventy cases of elderly patients with tibiofibular fractures were divided into observation group(n=35,anterior tibial tibial incision combined with locking compression plate internal fixation)and control group(n=35,conventional locking compression plate internal fixation)by random number table method.The therapeutic effects of the two groups were compared.Results The detumescence treatment time and hospitalization time of the observation group were shorter than those of the control group,and the postoperative drainage volume was less than that of the control group(P<0.05).Six months after operation,AOFAS ankle function scores of the two groups were higher than those before operation,and that of the observation group was higher than the control group(P<0.05).At 3 days after operation,the levels of serum MDA in both groups were higher than those before operation,the levels of serum SOD were lower than those before operation,and those of the observation group were better than the control group(P<0.05);at 7 days after operation,the levels of serum MDA in both groups were lower than those before operation,the levels of serum SOD were higher than those before operation(P<0.05),but but there were no significant differences in the levels of serum MDA and SOD between the two groups(P>0.05).The wound healing at one month after operation in the observation group was better than that in the control group(P<0.05).Conclusion Anterior tibial decompression incision combined with locking compression plate internal fixation in the treatment of elderly patients with tibiofibular fractures is helpful to restore ankle joint function,reduce oxidative stress reaction and promote surgical incision healing.