Comparative analysis of bone metabolism and inflammatory markers in tibiofibular fractures following closed reduction and fixation: A retrospective study.

Background: This study aimed to evaluate the effectiveness and safety of closed reduction and internal fixation (CRIF) versus closed reduction and external fixation (CREF) in treating tibiofibular fractures, focusing on their impact on bone metabolism and inflammatory responses.

Methods: A retrospective analysis was conducted on the clinical data of 95 patients with tibiofibular fractures, categorised into the CRIF group (CRIFG) and the CREF group (CREFG). Clinical efficacy, Visual Analogue Scale (VAS) scores, serum bone metabolism markers, serum inflammatory cytokines, Generic Quality of Life Inventory-74 (GQOLI-74) scores, and adverse reactions (AR) were compared between the groups.

Results: The total clinical efficacy rates were 80.49% (33/41) in the CRIFG and 85.19% (46/54) in the CREFG (P>0.05). Compared to CRIFG, the CREFG group exhibited significantly lower VAS scores and higher GQOLI-74 scores across all dimensions. Additionally, the CREFG group showed increased levels of serum osteocalcin (BGP), bone alkaline phosphatase (BALP), and N-terminal propeptide of type 1 procollagen (P1NP), along with decreased levels of type I collagen carboxy-terminal peptide b special sequence (b-CTX). Inflammatory markers, including C-reactive protein (CRP), interleukin-6 (IL-6), IL-1b, and tumour necrosis factor-a (TNF-a), were significantly lower in the CREFG group. The total AR rate was also lower in CREFG (18.52% vs. 31.71%, P<0.05).

Conclusions: Compared to CRIF, CREF treatment is more effective in reducing pain, enhancing bone metabolism, alleviating inflammatory responses, and improving the overall quality of life (QoL) in patients with tibiofibular fractures.