皮质骨螺钉固定与带袢钢板弹性固定在老年踝关节骨折下胫腓损伤患者中的应用效果比较

Application Effect of Cortical Bone Trajectory Fixation and Loop Steel Plate Elastic Fixation in Elderly Patients with Tibiofibular Injury Caused by Ankle Fracture

目的比较皮质骨螺钉(cortical bone trajectory,CBT)固定与带袢钢板弹性固定在老年踝关节骨折(fracture of ankle joint,FAJ)下胫腓损伤患者中的应用效果。方法选取2022年8月—2023年7月菏泽骨伤医院收治的92例老年FAJ下胫腓损伤患者为研究对象,根据不同治疗方法分为两组,各46例。对照组采用CBT固定治疗,研究组采用带袢钢板弹性固定治疗。比较两组术中与术后情况、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足评分(Ankle Hindfoot Scale,AHS)、并发症发生情况。结果两组术中操作时间、术中失血量比较,差异无统计学意义(P均>0.05)。研究组部分与完全负重活动时间均短于对照组,差异有统计学意义(P均<0.05)。术后6个月时,研究组AOFAS-AHS评分为(90.02±2.65)分,高于对照组的(85.02±2.75)分,差异有统计学意义(t=8.880,P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论与CBT相比,带袢钢板弹性固定可以有效缩短老年FAJ下胫腓损伤患者的部分与完全负重活动时间,促进踝关节功能恢复。

Objective To compare the application effect of cortical bone trajectory(CBT)fixation and loop steel plate elastic fixation in elderly patients with tibiofibular injury caused by fracture of ankle joint(FAJ).Methods A total of 92 elderly patients with FAJ tibiofibular injury admitted to Heze Orthopedics Hospital from August 2022 to July 2023 were selected as the research objects.They were divided into two groups according to different treatment method,with 46 cases in each group.The control group used CBT fixation treatment,the study group used loop steel plate elastic fixation treatment.The intraoperative and postoperative conditions,American Orthopaedic Foot and Ankle Society(AOFAS)Ankle Hindfoot Scale(AHS)score,and complications were compared between the two groups.Results There were no significant differences in operation time and intraoperative blood loss between the two groups(both P>0.05).The time of partial and full weight-bearing activity in the study group were shorter than those in the control group,and the differences were statistically significant(both P<0.05).At 6 months after surgery,the AOFAS-AHS score of the study group was(90.02±2.65)points,which was higher than(85.02±2.75)points of the control group,and the difference was statistically significant(t=8.880,P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Compared with CBT,loop steel plate elastic fixation can effectively shorten the partial and full weight-bearing activity time and promote the functional recovery of ankle joint in elderly patients with distal tibiofibular injury.