摘要
目的分析侧卧位与仰卧位髓内钉植入术治疗胫骨骨折的临床疗效及两种体位的优缺点。方法回顾性分析2016年1月—2018年1月河南省骨科医院足踝外科胫骨骨折患者68例,男性44例,女性24例;年龄23~69岁,平均51.5岁。患者行闭合复位髓内钉内固定治疗,根据手术体位不同分为仰卧位组(38例)和侧卧位组(30例),记录两组患者手术时间、术中出血量、术中C型臂X线机透视次数、术后感染情况、VAS评分、愈合情况等指标并比较两者的差异。结果仰卧位组手术时间(85.2±2.5)min,术中出血量(65.1±3.2)mL,术中C型臂X线机透视次数(14.0±0.7)次,术后切口感染2例,术后VAS评分(4.4±0.2)分;侧卧位组手术时间(77.9±2.2)min,术中出血量(55.2±2.5)mL,C型臂X线机透视次数(11.8±0.5)次,术后无切口感染,术后VAS评分(3.8±0.2)分。随访中两组患者骨折正常愈合,术后感染及愈合情况等指标差异无统计学意义;而手术时间、术中出血量及术中C型臂X线机透视次数比较差异有统计学意义(P<0.05)。结论侧卧位髓内钉内固定治疗胫骨骨折操作简便,髓内钉植入耗时短,X线片照射次数较少,术后疼痛程度低且术中患肢位置相对固定,且减少断端出血。
Objective To investigate the clinical efficacy of intramedullary nailing with lateral position or supine position in the treatment of tibia fractures and the differeces among the two operation positions.Methods From Jan.2016 to Jan.2018,clinical data of 68 patients with tibia fractures who underwent internal fixation with intramedullary nailing using closed reduction in the Department of Ankle and Foot Surgery of Henan Provincial Orthopedic Hospital were collected.There were 44 males and 24 females.The age was 23-69 years,with an average of 51.5years.According to the position during the operation,the patients were divided into supine position group(38 cases)and lateral position group(30 cases).The gender,age,fracture AO classification,operation time,intraoperative blood loss,X-ray irradiation times,and incision infection,and postoperative VAS score were recorded and compared between the two groups.Results The operation time of the supine position group was(85.2±2.5)minutes,the intraoperative blood loss was(65.1±3.2)mL,and the X-ray irradiation was(14.0±0.7)times.There were two cases of wound infection after operation.The postoperative VAS score was(4.4±0.2)points.However,the operation time of the lateral position group was(77.9±2.2)minutes,the intraoperative blood loss was(55.2±2.5)mL,and the X-ray irradiation was(11.8±0.5)times.There was no case of incision infection after operation.The postoperative VAS score was(3.8±0.2)points.Therefore,there was no difference in gender,age,fracture AO classification,postoperative incision infection or healing condition.There were significant differences in operation time,intraoperative blood loss and X-ray exposure(P<0.05).Conclusions Intramedullary nail fixation with lateral position for the treatment of tibia fractures is simple,time-saving with less X-ray exposure.The low postoperative pain scores and intraoperative blood loss are also found in surgery with the lateral position.
作者
霍纪宝
刘新江
HUO Ji-bao;LIU Xin-Jiang(Department of Ankle and Foot Surgery,Luoyang Zhenggu Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Zhengzhou 450000,China)
出处
《创伤外科杂志》
2020年第9期689-691,共3页
Journal of Traumatic Surgery
关键词
胫骨骨折
髓内钉
内固定
体位
tibia fracture
intramedullary nail
internal fixation
position
