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解剖锁定钢板内固定治疗孤立性腓骨远端骨折后完全负重:我们的机构经验。

Full weight bearing after internal fixation of isolated distal fibular fractures with anatomically contoured locking plates: Our institutional experience.

机构信息

Centre for Orthopaedic Surgery and Traumatology, North University Hospital, Marseille, Chemin des Bourrely, 13915 Marseille, France.

Centre for Orthopaedic Surgery and Traumatology, North University Hospital, Marseille, Chemin des Bourrely, 13915 Marseille, France.

出版信息

Injury. 2024 Jun;55 Suppl 1:111476. doi: 10.1016/j.injury.2024.111476. Epub 2024 Jul 26.

Abstract

Isolated fractures of the distal fibula mainly affect young, active people. In most cases, fixation is by open reduction with or without casting for six weeks without weight bearing. The current trend is to reduce this period of non-weight-bearing in order to promote earlier functional rehabilitation. The improved mechanical stability resulting from the use of plates with locking screws has changed the postoperative management of many fractures, but there is little evidence for the ankle. Between October 2013 and August 2015, 36 patients were enrolled in a prospective study to evaluate the performance of internal fixation of isolated distal fibular fractures using a lateral anatomically contoured titanium locking plate (InitialA® plate from Newclip Technics, Haute Goulaine, France) with immediate mobilisation and full weight bearing. No patient required further surgery due to mechanical failure or non-union. The bone healing rate was 100 % at 3 months. Two patients had septic complications requiring plate removal and antibiotic treatment and were eventually cured. The use of anatomically contoured locking plates provides strong and stable fixation, allowing immediate full weight-bearing. Such a technique has the advantage of a short recovery time and an early return to work without additional complications.

摘要

单纯的腓骨远端骨折主要影响年轻、活跃的人群。在大多数情况下,治疗方法是切开复位,辅以或不辅以石膏固定 6 周,不负重。目前的趋势是减少非负重期,以促进早期功能康复。锁定螺钉的使用提高了钢板的力学稳定性,改变了许多骨折的术后管理,但在踝关节方面证据很少。2013 年 10 月至 2015 年 8 月,36 例患者参与了一项前瞻性研究,评估使用外侧解剖轮廓钛锁定钢板(来自法国 Haute Goulaine 的 Newclip Technics 的 InitialA® 板)进行单纯腓骨远端骨折内固定的效果,术后即刻活动和完全负重。没有患者因机械故障或骨不连而需要进一步手术。3 个月时骨愈合率为 100%。2 例患者发生感染性并发症,需要取出钢板和抗生素治疗,最终治愈。使用解剖轮廓锁定钢板可提供牢固稳定的固定,允许立即完全负重。这种技术的优点是恢复时间短,早期返回工作岗位,无其他并发症。

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