Wei Yaheng, Yang Zuoming
Hebei Province Tangshan Second Hospital Trauma Five, Hebei, China.
Medicine (Baltimore). 2025 Jan 10;104(2):e41071. doi: 10.1097/MD.0000000000041071.
Ankle fractures are among the most common bone injuries, which are often accompanied by soft tissue injuries. Proper management of these fractures is crucial to promote healing and minimize complications. This study explores the effects of 2 treatment methods for ankle fractures: open reduction and internal fixation and manual reduction followed by plaster external fixation. A retrospective analysis was conducted on 124 patients with ankle fractures admitted between March 2020 and September 2022. Patients were divided into 2 groups: 62 received internal fixation and 62 received manual reduction with plaster external fixation. The study evaluated various clinical outcomes, including treatment effectiveness, recovery times, the incidence of nonunion, ankle joint function and inflammatory factors, and complication rates. The internal fixation group showed a significantly higher effective treatment rate (96.77%) compared to the non-internal fixation group (85.48%). After treatment, the internal fixation group had significantly lower medial malleolus space and talus tilt angles, indicating better fracture alignment. The internal fixation group also had shorter treatment, postoperative recovery, and functional recovery times. Furthermore, the incidence of nonunion and complications was lower in the internal fixation group. Inflammatory markers such as interleukin-6 (IL-6), C-reactive protein (CRP), and interleukin-8 (IL-8) decreased significantly in the internal fixation group compared to the non-internal fixation group. Internal fixation is more effective than manual reduction and plaster external fixation for treating ankle fractures. It leads to better fracture healing, shorter recovery times, and fewer complications, including nonunion. Manual reduction with external fixation remains a viable option but may be associated with a higher risk of nonunion and delayed healing. Early and effective management of soft tissue injuries is crucial for improving treatment outcomes in ankle fractures.
踝关节骨折是最常见的骨损伤之一，常伴有软组织损伤。正确处理这些骨折对于促进愈合和减少并发症至关重要。本研究探讨了两种踝关节骨折治疗方法的效果：切开复位内固定术和手法复位后石膏外固定术。对2020年3月至2022年9月收治的124例踝关节骨折患者进行了回顾性分析。患者分为两组：62例接受内固定，62例接受手法复位并石膏外固定。该研究评估了各种临床结果，包括治疗效果、恢复时间、骨不连发生率、踝关节功能和炎症因子以及并发症发生率。与非内固定组（85.48%）相比，内固定组的有效治疗率显著更高（96.77%）。治疗后，内固定组的内踝间隙和距骨倾斜角显著更低，表明骨折对线更好。内固定组的治疗、术后恢复和功能恢复时间也更短。此外，内固定组的骨不连和并发症发生率更低。与非内固定组相比，内固定组的炎症标志物如白细胞介素-6（IL-6）、C反应蛋白（CRP）和白细胞介素-8（IL-8）显著降低。对于治疗踝关节骨折，内固定比手法复位和石膏外固定更有效。它能带来更好的骨折愈合、更短的恢复时间以及更少的并发症，包括骨不连。手法复位外固定仍然是一种可行的选择，但可能与骨不连和延迟愈合的风险更高有关。早期有效处理软组织损伤对于改善踝关节骨折的治疗结果至关重要。
