微创经皮钢板内固定术与交锁髓内钉内固定术治疗胫骨远端闭合性骨折患者的效果比较

Comparison of effects of minimally invasive percutaneous plate internal fixation and interlocking intramedullary nail internal fixation in treatment of patients with closed fractures of the distal tibia

目的:比较微创经皮钢板内固定术与交锁髓内钉内固定术治疗胫骨远端闭合性骨折患者的效果。方法:回顾性分析2021年2月至2023年2月新蔡县人民医院收治的102例胫骨远端闭合性骨折患者的临床资料,按照手术方法不同将其分为观察组和对照组各51例。对照组行交锁髓内钉内固定术治疗,观察组行微创经皮钢板内固定术治疗。比较两组围术期指标(手术时间、骨折愈合时间、住院时间)水平,手术前后踝关节功能[美国矫形足踝协会踝-后足评分法(AOFAS-AH)]评分、炎性因子[降钙素原(PCT)、C反应蛋白(CRP)]水平,以及并发症发生率。结果:两组骨折愈合时间比较,差异无统计学意义(P>0.05);观察组手术时间、住院时间均短于对照组,差异有统计学意义(P<0.05);术后1、3个月,观察组AOFAS-AH评分均高于对照组,差异有统计学意义(P<0.05);术后3 d,观察组PCT、CRP水平均低于对照组,差异有统计学意义(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:微创经皮钢板内固定术治疗胫骨远端闭合性骨折患者可缩短手术时间和住院时间,提高踝关节功能评分,降低炎性因子水平,效果优于交锁髓内钉内固定术治疗。

Objective:To compare effects of minimally invasive percutaneous plate internal fixation and interlocking intramedullary nail internal fixation in treatment of patients with closed fractures of the distal tibia.Methods:The clinical data of 102 patients with closed fractures of the distal tibia admitted to Xincai county people’s hospital from February 2021 to February 2023 were retrospectively analyzed.According to different surgical methods,they were divided into observation group and control group,51 cases in each group.The control group was treated with interlocking intramedullary nail internal fixation,while the observation group was treated with minimally invasive percutaneous plate internal fixation.The perioperative indexes(operation time,fracture healing time,hospitalization time)levels,the ankle function[American Orthopaedic Foot and Ankle Society-ankle-hindfoot(AOFAS-AH)]score,the inflammatory factors[procalcitonin(PCT),C-reactive protein(CRP)]levels before and after surgery,and the incidence of complications were compared between the two groups.Results:There was no significant difference in the fracture healing time between the two groups(P>0.05).The operation time and the hospitalization time of the observation group were shorter than those of the control group,and the differences were statistically significant(P<0.05).At 1 and 3 months after the surgery,the AOFAS-AH scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).At 3 days after the surgery,the levels of PCT and CRP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Minimally invasive percutaneous plate internal fixation in the treatment of the patients with closed fractures of the distal tibia can shorten the operation time and the hospitalization time,improve the ankle function scores,and reduce the levels of inflammatory factors.Moreover,it is superior to interlocking intramedullary nail internal fixation.