摘要
目的比较专家型髓内钉与经皮锁定钢板固定治疗胫骨中下段骨折的临床疗效。方法对2010年2月~2015年2月应用专家型髓内钉与经皮锁定钢板两种手术方式治疗的胫骨中下段骨折患者共68例进行回顾性分析,其中专家型髓内钉组32例,经皮锁定钢板组36例。比较两组手术时间、术中出血量、住院时间、骨性愈合时间、术后并发症及踝关节功能。结果 68例患者均获随访,随访时间6~18个月。与经皮锁定钢板组比较,专家型髓内钉组手术时间长,术中出血量少,住院时间短(P均<0.05);两组骨折愈合时间及术后并发症率比较差异无统计学意义(P>0.05)。术后5个月按Johner-Wruhs评分评价疗效:专家型髓内钉组优22例,良8例,可2例;经皮锁定钢板组优25例,良8例,可3例;两组优良率分别为93.7%和91.7%,组间比较无统计学差异(P>0.05)。结论专家型髓内钉与经皮锁定钢板两种固定方法骨性愈合时间短、术后并发症少、术后踝关节功能恢复好、内固定稳定性强,均是治疗胫骨中下段骨折的良好选择。尤其是专家型髓内钉内固定,对局部软组织条件不佳者更加合适。
Objective To compare the clinical effect of internal fixation of expert tibia nail （ETN） and mini-invasive percutaneous locking plate （MILP） for treatment of middle-distal tibia fractures. Method A retrospective study was conducted on 68 middle-distal tibia fractures treated with ETN （32 cases） and MILP （36 cases） in our hospital from February 2010 to February 2015, and the efficacy of the two therapeutic method was compared. Results Sixty-eight cases were followed up for 6 to 18 months. Compare to MILP group, the operation time was longer, intra-operative blood loss was less and the hospital stays was shorter in ETN group, and the differences were statistically （ P 〈0.05）. However, there was no statistical difference in fracture healing duration and postoperative complication rate. According to Joher-Wruhs criteria, the result was revealed 22 cases of excellence, 8 cases of good and 2 cases of fair in the ETN group, and 25 of excellence, 8 of good and 3 of fair in the MILP group, there was no statistic difference in the fineness rate at 5 months after operation between the two groups （ 93.7% vs. 91.7%, P 〉0.05）. Conclusions Both ETN and MILP are the favorable ways for the treatment of middle-distal tibia fractures with obvious advantages in the short bone union, less postoperative complications as well as good function of the ankle joint. Therefore, ETN is much more suitable for the soft tissue injury of fracture.
作者
倪进荣
邓杰林
王立新
NI Jin-rong;DENG Jie-lin;WANG Li-xin(Department of Orthopaedics,The First People＇s Hospital of Suqian,Suqian 223800,Jiangsu,China;Department of Orthopaedics,Chongming Branch,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 202150,China)
出处
《中国现代手术学杂志》
2018年第3期196-200,共5页
Chinese Journal of Modern Operative Surgery
基金
上海市崇明区科学技术委员会项目(编号:CKY2015-03)
