Effect of Minimally Invasive Percutaneous Plate Osteosynthesis in the Treatment of Distal Tibiofibular Fracture and Risk Factors of Postoperative Deep Vein Thrombosis

ZHANG Zhen; ZHOU Tao; CHENG Fei; SHEN Jinhu; ZHOU Hui; YANG Liuzhong

doi:10.16458/j.cnki.1007-0893.2025.02.001

Abstract：Objective To investigate the efficacy of minimally invasive percutaneous plate internal fixation(MIPPO)in the treatment of distal tibiofibular fractures and the risk factors for postoperative deep vein thrombosis.Methods A total of 80 patients with distal tibial and fibular fractures treated with MIPPO at Xuzhou Hospital of Traditional Chinese Medicine from January 2022 to December 2023 were selected as the observation group,and another 80 patients with distal tibial and fibular fractures treated with traditional open reduction and internal fixation at Xuzhou Hospital of Traditional Chinese Medicine during the same period were selected as the control group.The perioperative indicators,incidence of complications,and ankle function before and after surgery in two groups of patients were analyzed.And 80 patients who received MIPPO treatment were divided into a deep vein thrombosis group(15 cases)and a non deep vein thrombosis group(65 cases)based on whether deep vein thrombosis occurred after surgery.The general situation of the two groups of patients was compared,and a logistics regression model was used to analyze the risk factors for deep vein thrombosis after MIPPO treatment for distal tibial and fibular fractures.Results The postoperative drainage volume and intraoperative bleeding volume of the observation group were lower than those of the control group.The operation time,first time out of bed,and hospitalization time were shorter than those of the control group,and the differences were statistically significant(P<0.05);The AOFAS scores of the observation group patients were higher than those of the control group at 1,3,and 6 months after surgery,and the differences were statistically significant(P<0.05);The total incidence of postoperative complications in the observation group(22.50%)was lower than that in the control group(38.75%),and the difference was statistically significant(P<0.05);There were statistically significant differences between the deep vein thrombosis group and the non deep vein thrombosis group in terms of age,concomitant hyperlipidemia,concomitant multiple injuries,D-dimer,hematocrit,and hemoglobin levels at admission(P<0.05);Age,multiple injuries,and hematocrit were independent risk factors for deep vein thrombosis after MIPPO treatment for distal tibial and fibular fractures(P<0.05).Conclusion Compared with traditional open reduction and internal fixation treatment,MIPPO treatment for distal tibial and fibular fractures has lower trauma,faster postoperative recovery,lower incidence of complications,and can further improve patients'foot and ankle function;However,the incidence of deep vein thrombosis after MIPPO surgery is still relatively high,which is influenced by factors such as age,multiple injuries,and hematocrit.