摘要
[目的]比较外支架和微创内固定治疗胫骨干C3.3骨折的疗效。[方法]回顾性分析2003年1月~2013年8月既适合外支架（A组,24例）又适合微创内固定（B组,30例）治疗患者的临床资料,比较两组患者一般资料、手术时间、患肢负重时间、骨折愈合时间、患肢功能恢复（Johner-Wruhs标准）、骨愈合困难和骨不连以及感染等并发症的发生率。[结果]随访18~48个月,平均24.2个月。两组患者的一般资料、开始负重时间、骨愈合困难和骨不连的发生率以及患肢功能恢复等方面比较,差异均无统计学意义（P〉0.05）,外支架仅在手术时间方面优于微创内固定,而微创内固定在骨折愈合时间、感染等并发症的发生率优于外支架,差异有统计学意义（P〈0.05）。[结论]尽管二者的患肢开始负重时间、骨愈合困难和骨不连的发生率以及功能恢复方面无明显差异,但微创内固定的骨折愈合时间和感染等并发症的发生率优于外支架,而且,外支架还有护理康复不便等缺陷。因此,对于既可选用外支架、又可选用微创内固定作为最终固定方法治疗的胫骨干C3.3骨折,综合而言,微创内固定优于外支架。
[ Objective] To compare the curative effects between external fixation and minimally invasive internal fixation in treatment of C3.3 tibia shaft fractures. [ Method] From January 2003 to Auguster 2013 ,cases of C3.3 tibia shaft fractures indi- cated for beth external fixation （group A,24 cases） and minimally invasivc internal fixation（ group B,30 cases） were retrospec- tively analyzed. The parameters for evaluation included general information, operation time, starting time of weight bearing, heal- ing time of fractures and functionary recovery on the affected extremity（ Johner- Wruhs＇s criterion）, as well as rates of difficult healing or nonunion and complication like infection. [ Result] All cases were followcd up for 15 to 28 months with an average of 20.2 months. There were no significant differences in general information, starting time of weight bearing, rate of difficult healing or nonunion and functionary recovery between two groups （ P 〉 0.05 ）, but the operation time in group A was shorter than that in group B, whereas the healing time, the rates of difficult healing or nonunion and complication in group A were higher than those in group B ,with significant difference（ P 〈 0.05 ）. [ Conclusion] Although there are no significant differences in starting time of weight bearing,functionary recovery between external fixation and minimally invasive internal fixation,healing time of fractures, rate of complication like infection in minimally invasive internal fixaiton group arc better than those in external fixation group. In addition, external fixation has disadvantages of inconvenience of rehabilitation and nursing. Therefore, in terms of comprehen- sive,minimally invasive internal fixation is superior to external fixation for C3.3 tibia shaft fractures indicated for beth external fixation and minimally invasive internal fixation.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2015年第22期2047-2051,共5页
Orthopedic Journal of China
关键词
胫骨干复杂骨折
固定
治疗效果
complex tibia fracture, fixation, curative effect
