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Effects of Micro Plate Internal Fixation and Cannulated Screw Internal Fixation on Ankle Joint Function and Inflammatory Response in Patients with Large Posterior Malleolus Fracture |
FENG Ji-qing, YAN Wei-jing |
Department of Orthopaedics, Yan'an People's Hospital, Yan'an 716000 |
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Abstract 【Objective】To investigate the clinical effect of internal fixation (micro plate and cannulated screw) on ankle function and inflammatory reaction in the treatment of large posterior malleolus fracture . 【Methods】From January 2017 to January 2019, 41 patients with massive posterior malleolus fractures were selected and divided into two groups according to the ball touch method: the observation group (n=21 cases) and the control group (n=20 cases). The observation group was treated with micro plate internal fixation, while the control group was treated with hollow nail internal fixation. The differences of clinical efficacy, clinical related indexes, postoperative complications and inflammatory indexes were compared between the two groups. The patients in the two groups were followed up for 12-13 months, and the changes of ankle function and mobility before and after treatment were compared. 【Results】All patients were followed up for an average of (12.5±0.2) months (range:12-13 months). The operation time of the control group was shorter than that of the observation group (P<0.05), however, the intraoperative blood loss was not significant between the observation group and the control group (P > 0.05).The time of ambulation, fracture healing and full weight-bearing in the observation group were shorter than those in the control group (P<0.05).The excellent and good rate of the observation group was better than that of the control group (P<0.05).The total incidence of postoperative wound infection, delayed union of fracture, articular surface collapse and screw loosening in the observation group was lower than that in the control group (P<0.05). After 12 months, the ankle flexion and dorsiflexion activities of the two groups were significantly improved compared to before operation, the ankle valgus and varus activities of the two groups were significantly lower than before operation, and the ankle joint activity of the observation group was significantly better than that of the control group (P<0.05).The scores of AOFAS and KPS at 12 months after surgery were higher than before surgery; and AOFAS and KPS scores in the observation group were significantly higher than those in the control group (P<0.05).The levels of serum CRP, IL-6 and IL-8 on day 30 after operation in the two groups were significantly lower than those before operation, and the levels of serum CRP, IL-6 and IL-8 in the observation group were lower than those in the control group on day 30 after operation (P<0.05). 【Conclusion】Microplate internal fixation is more effective in the treatment of ankle mass fracture, its ankle function recovery is better and inflammation is less.
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Received: 24 May 2021
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