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经髓内钉固定治疗 Danis-Weber B 型外踝骨折的临床研究。

Clinical study of intramedullary nailing fixation for the treatment of Danis-Weber B in lateral malleolus fracture.

机构信息

Department of Foot and Ankle Surgery, The Second Affiliated Hospital of Luohe Medical College, Luohe, Henan Province, China.

Department of Orthopaedics, The Second Affiliated Hospital of Luohe Medical College, Luohe, Henan Province, China.

出版信息

J Int Med Res. 2021 Oct;49(10):3000605211047371. doi: 10.1177/03000605211047371.

DOI:10.1177/03000605211047371
PMID:34713740
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8645306/
Abstract

OBJECTIVE

To compare the clinical effects between anatomical locking plates and interlocking intramedullary nails in patients with Danis-Weber B lateral malleolus fractures.

METHODS

This retrospective study enrolled patients with Danis-Weber B fractures of the lateral malleolus. All the operations were completed by the same group of surgeons. The reduction effect, operation time, intraoperative blood loss, hospital stay, fracture healing time and ankle functional outcomes (Olerud-Molander Ankle Score [OMAS]) were compared. Postoperative complications, including incision infections, fixation discomfort and internal fixation loosening, were also compared.

RESULTS

This study enrolled 73 patients that were treated with either an anatomical locking plate (locking plate group;  = 37) or an interlocking intramedullary nail (intramedullary nail group;  = 36). There was no significant difference between the two groups in terms of reduction effect, hospital stay and OMAS. The intramedullary nail group had significantly lower operation time, intraoperative blood loss and fracture healing time compared with the locking plate group. Postoperative complications in the intramedullary nail group were significantly lower compared with the locking plate group.

CONCLUSION

Using intramedullary nails resulted in more satisfactory functional outcomes compared with using locking plates in patients with Danis-Weber B fractures of the lateral malleolus.

摘要

目的

比较解剖锁定板与交锁髓内钉治疗 Danis-Weber B 型外踝骨折的临床疗效。

方法

本回顾性研究纳入了 Danis-Weber B 型外踝骨折患者。所有手术均由同一组外科医生完成。比较两组患者的复位效果、手术时间、术中出血量、住院时间、骨折愈合时间和踝关节功能(Olerud-Molander 踝关节评分[OMAS])。比较术后并发症,包括切口感染、固定不适和内固定松动。

结果

本研究纳入了 73 例患者,分别采用解剖锁定板(锁定板组;n  = 37)或交锁髓内钉(髓内钉组;n  = 36)治疗。两组患者在复位效果、住院时间和 OMAS 方面无显著差异。髓内钉组的手术时间、术中出血量和骨折愈合时间明显低于锁定板组。髓内钉组术后并发症明显低于锁定板组。

结论

与使用锁定板相比,对于 Danis-Weber B 型外踝骨折患者,使用髓内钉可获得更满意的功能结果。

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J Clin Med. 2021 Jul 2;10(13):2976. doi: 10.3390/jcm10132976.
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Surgical or non-surgical treatment of traumatic skeletal fractures in adults: systematic review and meta-analysis of benefits and harms.成人创伤性骨折的手术或非手术治疗:利弊的系统评价和荟萃分析。
Syst Rev. 2020 Aug 13;9(1):179. doi: 10.1186/s13643-020-01424-4.
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Intramedullary nailing of lateral malleolus in ankle fractures - surgical technique and literature review.踝关节骨折中外侧踝髓内钉固定术——手术技术及文献综述
Rev Col Bras Cir. 2020 Jun 15;47:e20202508. doi: 10.1590/0100-6991e-20202508. eCollection 2020.
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The Use of Modern Intramedullary Nailing in Distal Fibula Fracture Fixation.现代髓内钉在腓骨远端骨折固定中的应用
Foot Ankle Spec. 2019 Aug;12(4):322-329. doi: 10.1177/1938640018803734. Epub 2018 Oct 1.
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The implants used for intramedullary fixation of distal fibula fractures: A review of literature.用于腓骨远端髓内固定的植入物:文献回顾。
Int J Surg. 2018 Aug;56:294-300. doi: 10.1016/j.ijsu.2018.06.019. Epub 2018 Jun 28.
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Gait analysis related to functional outcome in patients operated for ankle fractures.踝关节骨折术后患者的步态分析与功能结果的关系。
J Orthop Res. 2019 Jul;37(7):1658-1666. doi: 10.1002/jor.24071. Epub 2019 Apr 12.
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Comparing intramedullary nailing and plate fixation for treating distal tibail fractures: A meta-analysis of randomized controlled trials.髓内钉与钢板固定治疗胫骨远端骨折的比较:一项随机对照试验的荟萃分析。
Int J Surg. 2018 May;53:5-11. doi: 10.1016/j.ijsu.2018.03.026. Epub 2018 Mar 16.
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The role of intramedullary fixation in ankle fractures - A systematic review.髓内固定在踝关节骨折中的作用——一项系统综述。
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