Wen Cheng, Wang Xi-Jie, Han Jun-Cheng, Wang Han-Wei
Department of Elderly Orthopaedics, Zhangjiakou Second Hospital, Zhangjiakou 075000, Hebei, China.
Zhongguo Gu Shang. 2023 Nov 25;36(11):1100-6. doi: 10.12200/j.issn.1003-0034.2023.11.018.
To investigate the effect of intramedullary nail fixation (IMN) and minimally invasive percutaneous plate internal fixation (MIPPO) techniques on tibiofibular fractures and their effect on platelet activation and serum transforming growth factor-β1 (TGF-β1) and bone morphogenetic protein-2 (BMP-2).
Total of 105 patients with tibiofibular fractures from February 2019 to February 2020 were selected and divided into 53 cases in the MIPPO group and 52 cases in the IMN group. There were 29 males and 24 females with an average age of (41.74±6.05) years old in MIPPO group;in IMN group, 31 males and 21 females with an average age of (40.59±5.26) years old. The perioperative surgical indexes, postoperative complications, ankle function recovery at 12 months postoperatively, platelet activation indexes at 3 and 7 days preoperatively and postoperatively, and serum TGF-β1 and BMP-2 levels at 4 and 8 weeks preoperatively and postoperatively were compared between the two groups.
The operating time and fracture healing time in the MIPPO group were shorter than those in the IMN group(<0.05); Compared with the preoperative period, the levels of GMP-140, PAC-1, CD63, and CD61 increased in both groups at 3 and 7 days after surgery, but were lower in the MIPPO group than in the IMN group(<0.05);the levels of serum TGF-β1 and BMP-2 increased in both groups at 4 and 8 weeks after surgery compared with the preoperative period, and the postoperative complication rate in the MIPPO group was lower than that in the IMN group(<0.05);the difference was not statistically significant in the excellent rate of ankle function recovery at 12 months follow-up after surgery between two groups(>0.05).
Both intramedullary nail fixation and MIPO technique for treatment of tibia and fibula fractures can improve ankle joint function, but the latter has the advantages of short operation time, fast fracture healing, fewer complications, and light platelet activation. Serum TGF-β1, BMP-2 level improves quickly.
探讨髓内钉固定（IMN）与微创经皮钢板内固定（MIPPO）技术治疗胫腓骨骨折的效果及其对血小板活化、血清转化生长因子-β1（TGF-β1）和骨形态发生蛋白-2（BMP-2）的影响。
选取2019年2月至2020年2月期间105例胫腓骨骨折患者，分为MIPPO组53例和IMN组52例。MIPPO组男29例，女24例，平均年龄（41.74±6.05）岁；IMN组男31例，女21例，平均年龄（40.59±5.26）岁。比较两组围手术期手术指标、术后并发症、术后12个月踝关节功能恢复情况、术前及术后3天和7天血小板活化指标，以及术前及术后4周和8周血清TGF-β1和BMP-2水平。
MIPPO组手术时间和骨折愈合时间短于IMN组（<0.05）；与术前相比，两组术后3天和7天GMP-140、PAC-1、CD63和CD61水平均升高，但MIPPO组低于IMN组（<0.05）；两组术后4周和8周血清TGF-β1和BMP-2水平较术前升高，且MIPPO组术后并发症发生率低于IMN组（<0.05）；两组术后12个月随访时踝关节功能恢复优良率差异无统计学意义（>0.05）。
髓内钉固定和MIPO技术治疗胫腓骨骨折均能改善踝关节功能，但后者具有手术时间短、骨折愈合快、并发症少、血小板活化轻的优点，血清TGF-β1、BMP-2水平提升快。
