摘要
目的:探讨胫腓骨骨干开放性骨折患者在经历外固定支架初步固定后,进一步实施内固定治疗的临床成效,旨在深刻剖析此联合疗法对患者骨折愈合动态及功能恢复的影响。方法:采用回顾性研究方法,将龙岩市第二医院2018年10月—2022年5月收治的胫腓骨骨干开放性骨折142例纳入研究,根据不同的治疗方案分为序贯内外固定组(71例)和单一外固定组(71例)。序贯内外固定组接受外伤后先外固定,二期改内固定的治疗方法;单一外固定组接受外伤清创后,二期行内固定的治疗方法。对比两组患者的骨痂成熟至愈合所需时间、膝关节和踝关节功能恢复情况、炎症因子指标、并发症发生情况。结果:序贯内外固定组的住院时间、骨痂成熟至愈合所需时间均短于单一外固定组,肿痛缓解时间早于单一外固定组(P<0.05)。出院7 d后,序贯内外固定组的膝关节和踝关节功能评分均高于单一外固定组(P<0.05)。出院7 d后,序贯内外固定组的降钙素原(PCT)、白细胞介素-6(IL-6)、细胞间黏附分子1(ICAM-1)、转化生长因子-β_(1)(TGF-β_(1))及C反应蛋白(CRP)水平均低于单一外固定组(P<0.05)。序贯内外固定组并发症发生率为1.41%(1/71),低于单一外固定组的11.27%(8/71)(X^(2)=5.813,P<0.05)。结论:胫腓骨骨干开放性骨折后先实施外固定支架术,再行内固定治疗,可促进骨折部位愈合,缩短康复周期,强化骨折稳定性,使关节功能全面恢复,控制炎症反应,安全性良好。
Objective:To investigate the clinical effect of further internal fixation therapy after initial fixation therapy with external fixation stent in patients with open tibia-fibula shaft fracture,in order to deeply analyze the influence of this combination therapy on fracture healing dynamics and functional recovery of patients.Method:By retrospective study,142 cases of open fractures of tibia and fibula shaft admitted to the Second Hospital of Longyan from October 2018 to May 2022 were included in the study,and they were divided into sequential internal and external fixation group(71 cases)and single external fixation group(71 cases)according to different treatment regimens.The sequential internal and external fixation group was treated with external fixation after trauma and internal fixation at second stage.The single external fixation group received the second stage of internal fixation after the trauma debridement.The time required for callus maturation to healing,functional recovery of knee joint and ankle joint,inflammatory factor index and occurrence of complications were compared between the two groups.Result:The duration of hospital stay and callus maturation to healing in the sequential internal and external fixation group were shorter than those in the single external fixation group,and the time of pain relief was earlier than that in the single external fixation group(P<0.05).7 days after discharge,the knee joint and ankle joint function scores in the sequential internal and external fixation group were higher than those in the single external fixation group(P<0.05).7 days after discharge,the levels of procalcitonin(PCT),interleukin-6(IL-6),intercellular adhesion molecule-1(ICAM-1),transforming growth factor-β_(1)(TGF-β_(1))and C reactive protein(CRP)in the sequential internal and external fixation group were lower than those in the single external fixation group(P<0.05).The incidence of complications in the sequential internal and external fixation group was 1.41%(1/71),lower than 11.27%(8/71)in the s
作者
黄魏翔
黄班华
马云杰
林万昌
游碧海
HUANG Weixiang;HUANG Banhua;MA Yunjie;LIN Wanchang;YOU Bihai(Orthopedics Department,the Second Hospital of Longyan,Longyan 364000,China;不详)
出处
《中国医学创新》
CAS
2024年第35期42-47,共6页
Medical Innovation of China
关键词
胫腓骨骨干开放性骨折
外固定支架术
内固定治疗
骨折愈合
并发症
Open fracture of tibia and fibula shaft
External fixation stenting
Internal fixation therapy
Fracture healing Complication
