小切口切开复位与经皮空心加压螺丝钉内固定治疗内踝骨折的效果对比

Comparative Study on the Therapeutic Effect of Small Incision Reduction and Percutaneous Hollow Compression Screw Internal Fixation in the Treatment of Internal Ankle Fractures

目的:比较小切口切开复位与经皮空心加压螺丝钉内固定治疗内踝骨折的效果。方法:选取2019年1月—2023年1月南通市通州区人民医院收治的84例内踝骨折患者作为研究对象,采用随机数表法随机分为切开组和闭合组,每组各42例。切开组行内踝小切口切开复位术,闭合组行经皮微创空心钉内固定术。比较两组的术中出血量、手术时间、骨痂形成时间、骨折愈合时间、肿痛消失时间、术后完全负重时间以及术后并发症情况和关节功能评分。结果:闭合组的手术时间、术中出血量均低于切开组,差异有统计学意义(P<0.05);两组骨痂形成时间比较,差异无统计学意义(P>0.05);闭合组的骨折愈合时间、肿痛消失时间以及完全负重时间均短于切开组,差异有统计学意义(P<0.05);闭合组术后并发症总发生率低于切开组,差异有统计学意义(P<0.05);闭合组的优良率高于对照组,差异有统计学意义(P<0.05)。结论:与传统的小切口切开复位法比较,经皮空心加压螺丝钉内固定术治疗踝关节骨折具有手术创伤小、恢复快、并发症少等优点。

Objective:To compare the effect of small incision reduction and percutaneous hollow compression screw internal fixation in the treatment of internal malleolar fracture.Method:A total of 84 patients with medial malleolar fracture admitted to Tongzhou District People's Hospital of Nantong City from January 2019 to January 2023 were selected as the study objects,and randomly divided into open group and closed group by random number table method,with 42 cases in each group.In the open group,small incision and reduction of the medial ankle were performed,while in the closed group,minimally invasive percutaneous hollow nail fixation was performed.The intraoperative blood loss,operation time,callus formation time,fracture healing time,swelling and pain disappearance time,postoperative full weight bearing time,postoperative complications and joint function score were compared between the two groups.Result:The operation time and intraoperative blood loss in the closed group were lower than those in the open group,and the difference was statistically significant(P<0.05).There was no significant difference in callus formation time between the two groups(P>0.05).The fracture healing time,swelling pain disappearance time and full weight-bearing time of closed group were shorter than those of open group,and the difference was statistically significant(P<0.05).The total incidence of postoperative complications in the closed group was lower than that in the open group,and the difference was statistically significant(P<0.05).The excellent and good rate of closed group was higher than that of control group,and the difference was statistically significant(P<0.05).Conclusion:Compared with the traditional small incision reduction method,the percutaneous hollow compression screws are internally fixed.