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全螺纹无头加压螺钉与部分螺纹松质骨拉力螺钉治疗内踝骨折:临床和影像学结果。

Fully threaded headless compression screw versus partially threaded cancellous lag screw in medial malleolus fractures: clinical and radiological outcomes.

机构信息

Department of Orthopaedics and Traumatology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Basin Sitesi, 35360, Izmir, Turkey.

Department of Radiology, Faculty of Medicine, Izmir Democracy University, Izmir, Turkey.

出版信息

Eur J Trauma Emerg Surg. 2021 Feb;47(1):179-185. doi: 10.1007/s00068-019-01207-0. Epub 2019 Aug 27.

Abstract

PURPOSE

The aim of this study was to evaluate the clinical and radiological results of medial malleolar fractures, which were treated with fully threaded headless compression screws and to compare the clinical and radiological results of this screws and partially threaded cancellous lag screws.

METHODS

Sixty-one patients who attended the final follow-up examination were included in the study. Group 1 comprised 29 patients applied with fully threaded headless compression screws and Group 2 comprised 32 patients with partially threaded cancellous lag screws. Radiological evaluation was made with standard radiographs. The clinical evaluations were applied using the AOFAS ankle hindfoot scale. Pain or sensitivity by touching over the medial malleolus was recorded and scored according to Visual Analog Scale.

RESULTS

No significant differences were determined between the groups with respect to age, gender, fracture type, follow-up time, bone union time and AOFAS scores. The medial sensitivity associated with implant irritation was significantly lower in Group 1. There was no need for removal of the fixation material in any patient of Group 1.

CONCLUSIONS

The results of this study showed satisfactory results in the two fixation techniques in medial malleolar fractures. However, the rates of medial sensitivity associated with implant irritation were lower in the group where fully threaded headless compression screws were used. Therefore, to prevent postoperative patient dissatisfaction caused by persistent medial sensitivity associated with implant irritation, despite successful surgical treatment, the primary choice may be fully threaded headless compression screws.

摘要

目的

本研究旨在评估经全螺纹无头加压螺钉治疗的内踝骨折的临床和影像学结果,并比较该螺钉和部分螺纹松质骨拉力螺钉的临床和影像学结果。

方法

纳入研究的 61 例患者均接受了最终随访检查。第 1 组 29 例患者采用全螺纹无头加压螺钉治疗,第 2 组 32 例患者采用部分螺纹松质骨拉力螺钉治疗。通过标准 X 线片进行影像学评估。采用美国足踝外科协会(AOFAS)踝-后足评分评估临床疗效。通过触诊内踝评估疼痛或敏感性,并根据视觉模拟评分(VAS)进行评分。

结果

两组患者在年龄、性别、骨折类型、随访时间、骨愈合时间和 AOFAS 评分方面无显著差异。第 1 组的内踝敏感性(与植入物刺激有关)显著较低。第 1 组无患者需要取出固定材料。

结论

本研究结果表明,两种内踝固定技术均取得了满意的效果。然而,在使用全螺纹无头加压螺钉的组中,与植入物刺激相关的内踝敏感性发生率较低。因此,为了防止因与植入物刺激相关的持续性内踝敏感性而导致术后患者不满意,尽管手术治疗成功,首选可能是全螺纹无头加压螺钉。

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