KẾT QUẢ PHẪU THUẬT ĐIỀU TRỊ GÃY KÍN ĐẦU DƯỚI HAI XƯƠNG CẲNG CHÂN BẰNG NẸP VÍT TẠI BỆNH VIỆN TRUNG ƯƠNG THÁI NGUYÊN

Abstract

Objective: To evaluate the surgical outcomes of closed distal tibia and fibula fractures treated with plate fixation at Thai Nguyen National Hospital. Subjects and Methods: A cross-sectional descriptive study was conducted on 51 patients with closed distal tibia and fibula fractures who underwent internal fixation with plates at the Department of Orthopedics, Thai Nguyen National Hospital, from June 2022 to January 2025. Results: The majority of patients were over 50 years old (61.0%), with males accounting for 62.7%. The predominant occupation was manual labor (49.0%). Regarding soft tissue healing, primary wound healing was achieved in 90.2% of patients. Radiographic assessment of fracture reduction according to Larson and Bostman criteria showed very good outcomes in 70.6% and good outcomes in 13.7% of cases. Bone healing, assessed by JL Hass criteria, was very good in 70.6% and good in 13.7%, while according to JY De La Cafiniere criteria, very good outcomes were observed in 68.6% and good in 15.7% of cases. Functional evaluation demonstrated normal or slightly limited ankle dorsiflexion/ plantarflexion in 76.5% and normal or slightly limited abduction/adduction in 70.6%. Overall clinical outcomes were rated as very good in 54.9%, good in 29.4%, and fair in 15.7% of patients. There was a statistically significant association between treatment outcomes and the interval from injury to surgery, operative time, and early postoperative mobilization (p < 0.05). Conclusion: Internal fixation using plate osteosynthesis for closed distal tibia and fibula fractures at Thai Nguyen National Hospital yielded favorable results: 90.2% good wound healing, more than 80% very good/good outcomes in fracture reduction and union, and satisfactory restoration of ankle joint function. Treatment outcomes were significantly influenced by surgical timing, operative duration, and early mobilization (p < 0.05). Early surgery (<7 days), reduced operative time (<120 minutes), early mobilization, and comprehensive rehabilitation should be prioritized to optimize treatment effectiveness.