摘要
目的：观察微创经皮钢板与交锁髓内钉固定治疗胫骨下端骨折临床疗效的差异，指导临床合理治疗。方法回顾分析70例胫骨下端骨折的临床病例资料，按内固定方式不同分为微创经皮锁定加压钢板固定治疗（A 组）与交锁髓内钉固定治疗（B 组），每组各35例，比较两组患者手术时间、出血量、骨折愈合时间、住院时间，术后1个月、3个月、6个月、9个月、12个月的踝关节评分，观察并发症（松动、断钉、深部感染、浅表感染、延迟愈合、畸形愈合、关节疼痛）发生情况，采用 Johner Wruh 法评价两组术后胫骨功能恢复的临床疗效。结果 A 组和 B 组手术时间分别为（130．2±40．1）min 和（96．4±30．5）min，A 组明显长于 B 组（t ＝3．853，P ＜0．05），A 组出血量、骨折愈合时间、住院时间与 B 组差异无统计学意义（t ＝0．336、0．228、1．743，均 P ＞0．05）。A 组术后1个月、3个月、6个月、9个月、12个月的踝关节评分与 B 组差异无统计学意义（t ＝0．855、1．315、1．527、0．787、0．885，均 P ＞0．05）。A 组和 B 组胫骨功能恢复临床疗效分别为97．14％比94．29％，差异无统计学意义（χ2＝0．354，P ＞0．05）。A 组和 B 组松动、断钉、深部感染、浅表感染、延迟愈合发生率差异无统计学意义（χ2＝0、0．348、1．014、3．134、0．348，均 P ＞0．05），A 组和 B 组组畸形愈合、关节疼痛发生率分别为2．86％和20％，25．71％和48．57％，A 组明显低于 B 组，差异均有统计学意义（χ2＝5．081、3．916，均 P ＜0．05）。结论微创经皮锁定加压钢板和交锁髓内钉内固定均可有效治疗胫骨下端骨折，两者临床疗效相当，但微创经皮钢板固定术具有更低畸形愈合和膝关节疼痛发生率，适合骨折部软组织条件良好的患者，但对于骨折部软组织条件差者，或者骨折部软组织条件
Objective To observe the effect of interlocking minimally invasive percutaneous plating and interlocking intramedullary nailing in treating fractures of the lower tibia,thus to guide clinical treatment.Methods A retrospective analysis of 70 patients with tibial fractures of the lower tibia were made.All the patients were divided into interlocking minimally invasive percutaneous plating group （A group）and interlocking intramedullary nailing group （B group）,35 cases in each group.The operative time,blood loss,fracture healing time,hospitalization time were compared,the ankle score after 1 month,3 months,6 months,9 months,12 months were recorded,the complica-tions（loose,broken nails,deep infection,superficial infection,delayed union,malunion,joint pain）were observed,the Johner Wruh method was used to evaluate the clinical efficacy of postoperative tibial functional recovery.Results The operative time of A group and B group were （130.2 ±40.1）min and （96.4 ±30.5）min,A group was signifi-cantly longer than B group （t =3.853,P 〈0.05）.There were no differences between A group and B group in bleed-ing amount,fracture healing time,hospitalization time （t =0.336,0.228,1.743,all P 〉0.05）.There were no differ-ences between A group and B group in the ankle score after 1 month,3 months,6 months,9 months,12 months（t =0.855,1.315,1.527,0.787,0.885,both P 〉0.05）.The clinical efficacy of tibia functional recovery in A group and B group were 97.14% and 94.29%,the difference was not statistically significant （χ2 =0.354,P 〉0.05）.The inci-dence rates of loose,broken nails,deep infection,superficial infection,delayed healing in A group and B group had no difference （χ2 =0,0.348,1.014,3.134,0.348,all P 〉0.05）,the incidence rates of malunion and joint pain in A group and B group were 2.86% and 20%,25.71% and 48.57%,which of A group were significantly lower than Bgroup,the differences were statistically significant （χ2 =5.081,3.916,all P 〈0.05）.Conclusion Interlocking min-imally i
出处
《中国基层医药》
CAS
2016年第16期2469-2472,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
胫骨骨折
骨固定钢丝
骨折固定术
疗效比较研究
Tibial fractures
Bone wires
Fracture fixation,intramedullary
Comparative effectiveness research
