微创经皮钢板内固定术对胫骨Pilon骨折患者膝、踝关节功能及骨代谢的影响

Effects of minimally invasive percutaneous plate internal fixation on knee and ankle joint function and bone metabolism in patients with tibial Pilon fractures

目的分析微创经皮钢板内固定术对胫骨Pilon骨折患者膝、踝关节功能及骨代谢的影响。方法抽取2020年1月至2022年1月临汾市人民医院收治的72例胫骨Pilon骨折患者作为研究对象,按照随机数字表法分为对照组和研究组,每组36例。对照组行切开复位钢板内固定术治疗,研究组行微创经皮钢板内固定术治疗。比较两组治疗前后膝关节协会评分(KSS)、踝关节功能评分(AOFAS)及骨代谢指标[I型前胶原氨基端前肽(PINP)、甲状旁腺激素(PTH)]波动情况。结果治疗前,两组KSS、AOFAS、骨代谢指标比较差异均未见统计学意义(P均>0.05);治疗3个月后,研究组各项KSS均高于对照组,研究组AOFAS[(85.41±8.69)分]高于对照组[(80.12±8.22)分],研究组PINP水平[(72.15±7.53)μg/L]低于对照组[(83.54±8.67)μg/L]、PTH水平[(37.56±3.87)ng/L]高于对照组[(25.63±2.79)ng/L],差异均有统计学意义(P均<0.05)。结论微创经皮钢板内固定术在胫骨Pilon骨折的治疗中更具优势,有助于膝、踝关节功能恢复,对骨代谢影响较少。

Objective To analyze the effect of minimally invasive percutaneous plate internal fixation on knee joint ankle joint function and bone metabolism in patients with tibial Pilon fractures.Methods A total of 72 patients with tibial Pilon fractures admitted to Linfen People’s Hospital from January 2020 to January 2022 were selected as the study subjects,and they were divided into control group and study group by random number table method,with 36 patients in each group.The control group underwent open reduction and internal fixation with steel plate,while the study group was treated by minimally invasive percutaneous plate internal fixation.The fluctuation of Knee Society Score(KSS),American Orthopedic Foot and Ankle Society(AOFAS)score,and bone metabolism indicators,including procollagen I N-terminal propeptide(PINP)and parathyroid hormone(PTH),before and after treatment were compared between the two groups.Results Before treatment,there were no statistically significant difference in KSS,AOFAS score,and bone metabolism indicators between the two groups(all P>0.05).After 3 months of treatment,each KSS score of the study group was higher than that of the control group,correspondingly,the AOFAS score of the study group(85.41±8.69)was higher than that of the control group(80.12±8.22),what’s more,the PINP level in the study group was(72.15±7.53)μg/L,which was lower than the(83.54±8.67)μg/L in the control group,while the PTH level in the study group was(37.56±3.87)ng/L,which was higher than the(25.63±2.79)ng/L in the control group(all P<0.05).Conclusions Minimally invasive percutaneous plate internal fixation has more advantages in the treatment of tibial Pilon fractures,which is helpful to the recovery of knee and ankle joint function,and has less impact on bone metabolism.