内踝骨折治疗-切开复位内固定与闭合复位经皮内固定的放射学效果比较研究

Prabhu Ethiraj, Sagar Venkataraman, A. Shanthappa, Sandesh Agrawal
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摘要

背景内踝骨折是当今骨科实践中常见的骨折。根据骨折类型和社会经济地位的不同,有不同的治疗方法。未移位骨折可通过铸造处理。治疗内踝骨折有多种手术方式,如张力带钢丝、松质螺钉或皮质螺钉固定、钢板固定、克氏针和缝合锚钉。本研究的目的是评估内踝骨折经皮切开复位内固定和闭合复位内固定的放射学结果。材料与方法本研究纳入67例符合纳入标准的患者,分为两组。组1包括52例内踝骨折患者,采用松质螺钉或张力带钢丝切开复位内固定。第二组15例采用空心松质螺钉闭合复位内固定。术后1个月、2个月、3个月、6个月和1年对所有患者进行评估。我们评估了患者的临床和放射学骨折愈合情况。结果本组67例患者中,男性居多,平均年龄46.55岁。右侧骨折多于左侧骨折。最常见的伤害方式是道路交通事故。在我们的研究中,横向骨折类型较多。组1平均愈合时间13.46周,组2平均愈合时间15.14周。1组骨折愈合率为96.15%,2组骨折愈合率为93.33%。结论与经皮内固定相比,切开复位内固定患者的平均放射愈合时间更早。这可能是由于在切开复位内固定技术中骨折部位的直接可视化和骨折碎片的良好近似。
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Medial Malleolar Fracture Management—A Comparative Study of Radiological Outcome between Open Reduction Internal Fixation and Closed Reduction Percutaneous Fixation
Background Medial malleolus fracture is commonly seen nowadays in orthopaedic practice. There are different modalities of treatment based on fracture pattern and socioeconomic status. Undisplaced fracture can be managed by cast application. Various surgical modalities of treatment are available in treating medial malleolus fracture like tension band wiring, cancellous screw or cortical screw fixation, plate fixation, Kirschner wire, and suture anchors. The purpose of our study was to evaluate radiological outcome of medial malleolus fracture managed with open reduction internal fixation and closed reduction percutaneous fixation. Materials and Methods Our study included 67 patients who met inclusion criteria and were divided into two groups. Group 1 included 52 patients with medial malleolar fractures cases and were treated with open reduction and internal fixation either by cancellous screw fixation or tension band wiring. Other 15 patients in group 2 were treated by closed reduction and internal fixation with cannulated cancellous screw. All postoperative patients were evaluated at 1st month, 2nd month, 3rd month, 6th month, and 1 year. We evaluated patient clinically and radiological union of fractures. Results In our study out of 67 patients there was male preponderance and average age was 46.55 years. Right-side fractures were more compared with left-side fractures. Most common mode of injury was road traffic accident. Transverse fracture pattern was more in number in our study. Average union time in group 1 was 13.46 weeks and group 2 is 15.14 weeks. Fracture union was 96.15% in group 1 and in group 2 was 93.33%. Conclusion In our study, average radiological union time in patients treated with open reduction internal fixation was early compared with percutaneous fixation. This could be due to direct visualization of fracture site and good approximation of fracture fragments in open reduction internal fixation technique.
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