METHODS: The 60 patients with tibiofibular fractures admitted from January 2015 to December 2022 were divided into two groups:intramedullary nail group and plate group, 30 cases each, intramedullary nail group was treated with elastic intramedullary nail fixation group, plate group was treated with steel plate and screw fixation group. Intramedullary nail group, there were 18 males and 12 females, aged from 22 to 75 years old with an average of (39.4±9.8) years old, including 24 cases of traffic accidents injury, 6 cases of falling injury, 23 cases of closed fractures, 7 cases of open fractures. Steel plate group, there were 15 males and 15 females, aged from 24 to 78 years old with an average of (38.6±10.2) years old. The 22 cases were injured by traffic accident, 8 cases were injured by falling. The 24 cases were closed fractures and 6 cases were open fractures. The operation time, intraoperative bleeding, American Orthopedic Foot and Ankle Society (AOFAS) ankle and hind foot scores, clinical healing time of fibula and the incidence of wound complications were compared between the two groups.
RESULTS: The patients in both groups were followed up for 6 to 21 months, with an average of (14.0±2.8) months. Compared with plate group, intramedullary nail group had shorter operative time, less bleeding, shorter clinical healing time of fibula, and lower infection rate of incision, and the difference was statistically significant (P<0.05). There were 2 cases of delayed healing in intramedullary nail group, 1 case of nonunion in plate group, and 2 cases of delayed healing in plate group, and there was no statistically significant difference between the two groups (P>0.05). In the last follow-up, according to the AOFAS scoring standard, the ankle function in intramedullary nail group was excellent in 17 cases, good in 12 cases, fair in 1 case, with an average of (88.33±4.57) points, while in plate group, excellent in 16 cases, good in 10 cases, fair in 4 cases, with an average of (87.00±4.14) points;There was no statistical difference between the two groups (P>0.05).
CONCLUSIONS: Elastic intramedullary nail has the advantages of short operation time, less intraoperative bleeding, short fracture healing time and less incision complications in the treatment of fibular fracture, which is worthy of clinical application.
方法:将2015年1月至2022年12月收治的60例胫腓骨骨折患者分为髓内钉组和钢板组。各30例,髓内钉组采用弹性髓内钉固定治疗,钢板组采用钢板螺钉固定组。髓内钉组,有18名男性和12名女性,年龄在22至75岁之间,平均(39.4±9.8)岁,包括24例交通事故伤害,6例坠落伤,23例闭合性骨折,7例开放性骨折。钢板组,有15名男性和15名女性,年龄24~78岁,平均(38.6±10.2)岁。这22人是因交通事故受伤,8例跌倒受伤。24例为闭合性骨折,6例为开放性骨折。操作时间,术中出血,美国矫形足踝协会(AOFAS)踝关节和后足评分,比较两组腓骨临床愈合时间及创面并发症发生率。
结果:两组患者均获得6~21个月的随访,平均(14.0±2.8)个月。与平板组相比,髓内钉组手术时间较短,出血少,腓骨临床愈合时间较短,切口感染率较低,差异有统计学意义(P<0.05)。髓内钉组延迟愈合2例,钢板组骨不连1例,钢板组延迟愈合2例,两组比较差异无统计学意义(P>0.05)。在最后的后续行动中,根据AOFAS的评分标准,髓内钉组踝关节功能优17例,在12个案例中很好,在一种情况下公平,平均(88.33±4.57)点,在板块组中,16例优秀,在10个案例中很好,在4个案例中公平,平均(87.00±4.14)分,两组比较差异无统计学意义(P>0.05)。
结论:弹性髓内钉具有手术时间短的优点,术中出血少,腓骨骨折愈合时间短,切口并发症少,值得临床推广应用。