摘要
为探讨经单切口对胫腓骨中下段双骨折同时内固定的可行性。将97例胫腓骨中下段骨折患者随机分成两组,A组取小腿前侧单切口行胫骨钢板内固定和腓骨克氏针内固定,B组取小腿前侧和腓骨外侧双切口行胫骨钢板内固定和腓骨重建钢板内固定。对两组手术时间、出血量、切口愈合时间、骨折愈合时间及踝关节并发症进行比较。结果胫骨愈合时间A组平均4.9个月,B组4.8个月(t=0.748);腓骨愈合时间A组平均3.2个月,B组3.8个月(P<0.05);手术时间A组平均57分钟,B组110分钟(P<0.05);出血量A组平均83ml,B组110ml(P<0.05);切口愈合时间A组平均13.7天,B组13.9天(t=0.552)。术后A组无感染,B组1例;皮肤切口出现边缘坏死A组3例,B组7例(χ2=0.93)。无筋膜间隙综合征发生。最后1次随访行走时有踝关节疼痛者A组5例,B组7例(χ2=0.33)。表明经单切口进行胫腓骨内固定治疗,可以缩短手术时间,减少出血量,降低切口愈合不良风险,并显著缩短腓骨愈合时间,在内固定稳定性方面有着与钢板相同的效果。
In order to study the therapeutic feasibility of internal fixation by single-cut to treat fracture of middle and lower part of the tibia and fibula(FTF), 97 cases of FTF were randomly divided into two groups: group A (treated by single-cut at cruralis anterior with internal fixation steel plate for tibia and pins for fibia) and group B (treated by dual-cut at cruralis anterior and fibular exterior with steel plate); The operative time, amount of bleeding, cut and fracture healing and the ankle complication of the two groups was observed and compared. The results showed that the time of tibial fracture healing of the two groups was 4.9 m and 4.8 m, respectively(T=0.748), the time of fibular fracture healing of the two groups was 3.2 m and 3.8 m(with significant difference<0.05), and the operative time of the two groups were 57 minutes and 110 minutes(P<0.05), amount of bleeding were 83ml and 110ml(P<0.05),and the time of cut healing were 13.7 d and 13.9 d(T=0.552),there was no infection in group A while 1 case in group B, there 3 cases and 7 cases in the two groups occurred putrescence at the fringe of skin(χ2=0.93), no case occurred myofascial syndrome, the cases of ankle pain in the two groups at the last follow-up were 5 cases and 7 cases, respectively(χ2=0.33), suggesting that internal fixation by single-cut to treat fracture of FTF has an advantage over by dual-cut in effect and complication.
出处
《中医正骨》
2007年第5期11-11,15,共2页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
胫腓骨骨折/治疗
骨折固定术
节口/方法
临床研究
fracture of the tibia and fibula / therapy, fracture fixation, cut/method ,clinical study
