摘要
目的比较髓内钉(IMN)和微创钢板内固定(MIPO)治疗骨折分类系统(AO)分型42A1型和42B1型胫骨干骨折的效果。方法回顾性分析2007年1月至2017年1月长治市第二人民医院收治的52例AO分型42A1型和42B1型胫骨干骨折患者的临床资料,按照治疗方法不同分为MIPO组与IMN组,每组26例。比较两组患者的麻醉方式、手术时间、影像学提示骨痂形成时间;比较两组患者的感染、畸形愈合、延迟愈合情况,比较两组患者随访6个月和2年的下肢功能评分(LEFS)。结果两组患者的麻醉方式比较,差异无统计学意义(P>0.05)。MIPO组的手术时间长于IMN组,差异有统计不意义(P<0.05)。两组患者的随访时间、影像学提示骨痂形成时间比较,差异无统计学意义(P>0.05)。两组患者的感染情况、畸形愈合、延迟愈合发生率比较,差异无统计学意义(P>0.05)。MIPO组的术后解剖复位率高于IMN组,膝前疼痛发生率低于IMN组,差异有统计学意义(P<0.05)。随访6个月,MIPO组的LEFS评分低于IMN组,差异有统计学意义(P<0.05),但随访2年两组的LEFS评分比较,差异无统计学意义(P>0.05)。结论MIPO和IMN两种治疗方法在临床和功能结果方面相似,且MIPO在一定方面可有效避免IMN带来的特定并发症,推荐MIPO作为治疗AO分型42A1型和42B1型胫骨干骨折的IMN的替代方法。
Objective To compare the efficacy of intramedullary nail(IMN)and minimally invasive plate osteosynthesis(MIPO)in the treatment of 42A1 and 42B1 tibial shaft fractures classified by Arbeitsgemeinschaftfür OsteSyntheefragen(AO).Methods The clinical data of 52 patients with AO type 42A1 and 42B1 tibial shaft fractures treated in the Second People′s Hospital of Changzhi City from January 2007 to January 2017 were retrospectively analyzed.According to different treatment methods,they were divided into MIPO group and IMN group,with 26 cases in each group.The methods of anesthesia,operation time and the time of callus formation were compared between the two groups.The infection,malunion and delayed healing of the two groups were compared,and the lower limb function score(LEFS)of the two groups were compared after 6 months and 2 years of follow-up.Results There was no significant difference in anesthesia mode between two groups(P>0.05).The operation time of MIPO group was longer than that of IMN group,the difference was statistically significant(P<0.05).There were no significant differences in the follow-up time and the time of callus formation between the two groups(P>0.05).There were no significant differences in infection,malunion and delayed union between the two groups(P>0.05).The postoperative anatomical reduction rate of MIPO group was higher than that of IMN group,and the incidence of anterior knee pain was lower than that of IMN group,the difference was statistically significant(P<0.05).After 6 months of follow-up,the LEFS score of MIPO group was lower than that of IMN group,the difference was statistically significant(P<0.05),but there was no significant difference of LEFS score between the two groups after 2 years of follow-up(P>0.05).Conclusion MIPO and IMN are similar in clinical and functional results,and MIPO can effectively avoid specific complications caused by IMN in some aspects,MIPO is recommended as an alternative to IMN in the treatment of AO type 42A1 and 42B1 tibial shaft fractures.
作者
秦慧永
王俊生
宋晓亮
QIN Huiyong;WANG Junsheng;SONG Xiaoliang(First Ward of Traumatic Orthopedic,the Second People′s Hospital of Changzhi City,Shanxi Province,Changzhi046000,China)
出处
《中国当代医药》
CAS
2022年第17期92-96,共5页
China Modern Medicine
关键词
髓内钉
微创钢板内固定
42A1型和42B1型胫骨干骨折
手术
疗效
Intramedullary nail
Minimally invasive plate internal fixation
42A1 and 42B1 tibial shaft fractures
Operation
Curative effect
