组织工程与重建外科杂志2024，Vol.20Issue(1)：87-92,6.DOI:10.3969/j.issn.1673-0364.2024.01.008
显微外科技术联合组合式外固定架在胫腓骨远端骨折伴严重软组织损伤中的应用
Application of microsurgical technique plus combined external fixator in distal tibia-fibula fractures with severe soft tissue injury
摘要
Abstract
Objective To explore the application effect of microsurgical technique plus combined external fixator in the treatment of distal tibia-fibula fracture with severe soft tissue injury.Methods A total of 84 patients with distal tibia-fibula fracture with severe soft tissue injury from January 2021 to June 2022 were selected and divided into two groups according to different treatment methods:41 patients treated with elastic intramedullary nail were included in the control group,and 43 patients treated with microsurgical technique combined with external fixators were included in the observation group.The operation related situation,postoperative efficacy,postoperative complications,X-ray callus score,serum indexes(BMP-2,VEGF,TGF-β),ankle function(AOFAS)score,Molander ankle fracture scoring system(OMAS)score were compared between the two groups.Results The time of preoperative preparation,operation,hospitalization,complete weight bearing,wound healing and fracture healing in the observation group were shorter than those in the control group,and the times of wound dressing changes were less than those in the control group(P＜0.05).The X-ray callus score of the observation group was higher than that of the control group at 1 and 3 months after surgery(P＜0.05).The levels of serum BMP-2,VEGF and TGF-β in the observation group were higher than those in the control group at 1 month and 3 months after surgery(P＜0.05).Three months after operation,the good and excellent rate of operation,AOFAS and OMAS scores in observation group were higher than those in control group,and the incidence of postoperative complications was lower than that in the control group(P＜0.05).Conclusion Microsurgical technique plus combined external fixator in the treatment of distal tibia-fibula fracture with severe soft tissue injury can effectively fix the fracture,better protect and promote soft tissue repair,promote fracture healing and early limb functional recovery,and reduce the risk of complications.关键词
胫腓骨骨折/软组织损伤/显微外科技术/组合式外固定架/X射线骨痂评分/踝关节功能Key words
Tibia-fibula fracture/Soft tissue injury/Microsurgical techniques/Combined external fixator/X-ray callus score/Ankle joint function分类
医药卫生引用本文复制引用
李克亚,刘鹏,王胜杰,刘兵..显微外科技术联合组合式外固定架在胫腓骨远端骨折伴严重软组织损伤中的应用[J].组织工程与重建外科杂志,2024,20(1):87-92,6.基金项目
河北省医学科学研究重点课题计划(20177058). （20177058）
