空心钉与钢板内固定治疗老年后踝骨折患者的临床疗效

Clinical efficacy between hollow screw and plate internal fixation in the treatment of elderly patients with posterior malleolar fracture

目的探讨空心钉与钢板内固定治疗老年后踝骨折的临床疗效。方法选择2018年1月至2020年7月在我院住院治疗的老年后踝骨折患者112例为研究对象,按随机数字表法分为观察组与对照组,每组各56例,观察组实施空心钉固定,对照组实施钢板内固定。比较两组的术中出血量、下床活动的时间、住院时间及骨折愈合时间、术后半年两组的美国足踝外科学会(AOFAS)评分、Olerud-Molander主观功能评分(OMA)评分、视觉模拟评分(VAS)以及并发症的总发生率。结果观察组下床活动时间、住院时间、骨折愈合时间均短于对照组,差异有统计学意义(P<0.05)。术后半年两组的AOFAS和OMA评分均较术前明显提高,且观察组高于对照组,差异有统计学意义(P<0.05)。术后半年两组的VAS评分较术前明显降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症的总发生率(3.58%)低于对照组(14.28%),差异有统计学意义(P<0.05)。结论与钢板内固定比较,空心螺钉治疗老年后踝骨折的临床疗效相对较好,能够有效改善其踝关节功能,安全性也较高。

Objective To explore the clinical effects of hollow screw and plate internal fixation in the treatment of senile posterior malleolus fracture.Methods A total of 112 elderly patients with posterior malleolus fracture hospitalized in our hospital from January 2018 to July 2020 were selected as observation objects,and they were randomly divided into the observation group and the control group,with 56 cases in each group.The observation group was fixed with hollow screws and the control group with plate internal fixation.Intraoperative blood loss,time of getting out of bed,hospital stay and fracture healing time,American Board of Foot&Ankle Surgery(AOFAS)score,Olerud-Molander Ankle(OMA)score,visual analogue scale(VAS)and the total incidence of complications of the two groups were compared.Results The time of getting out of bed,hospital stay and fracture healing in the observation group were shorter than those in the control group,with statistically significant differences(P<0.05).Six months after operation,AOFAS and OMA scores of the two groups were significantly higher than those before operation,and the scores of observation group were higher than that of the control group,with statistically significant differences(P<0.05).Six months after operation,the VAS scores of the two groups were significantly lower than those before operation,and the observation group was lower than that of the control group,with statistically significant difference(P<0.05).The total incidence of complications in the observation group(3.58%)was lower than that in the control group(14.28%),and the difference was statistically significant(P<0.05).Conclusion Compared with plate internal fixation,hollow screws have better clinical effect in the treatment of senile posterior malleolar fracture,which can effectively improve the ankle function and has higher safety.