CAJ | 학술논문

目的比较两种不同外固定支架治疗胫骨远端骨折的疗效.方法对2005年8月至2010年2月分别采用跨关节单边外固定支架和双边组合式外固定支架治疗并获得随访的38例胫骨远端骨折患者资料进行分析,其中单边外固定支架组(A组)23例,男16例,女7例;年龄24～64岁,平均46.5岁;双边外固定支架组(B组)15例,男11例,女4例;年龄32～65岁,平均49.1岁,记录骨折愈合时间、并发症发生率,并按照美国足踝外科协会(AOFAS)的标准评价踝关节功能,比较两组患者的疗效.结果所有患者术后获6～48个月(平均21个月)随访.骨折愈合时间:A组为3.5～12个月,平均(6.8±2.0)个月;B组为3～10个月(平均5.6±1.5)个月,两组比较差异有学意义(t=2.074,P=0.046).按照AOFAS标准进行评分:A组平均为(76.7±13.5)分,外固定期间并发症发生率为34.8%(8/23);B组平均为(74.4±13.6)分,外固定期间并发症发生率为40.0%(6/15).两组并发症发生率与AOFAS评分比较差异无统计学意义(P>0.05).结论单边外固定支架固定与双边组合式外固定支架固定均是治疗胫骨远端骨折的有效固定方式,在骨折愈合的时间方面,双边外固定支架较单边外固定支架具有优势.
목적 비교량충불동외고정지가치료경골원단골절적료효.방법 대2005년8월지2010년2월분별채용과관절단변외고정지가화쌍변조합식외고정지가치료병획득수방적38례경골원단골절환자자료진행분석,기중단변외고정지가조(A조)23례,남16례,녀7례;년령24～64세,평균46.5세;쌍변외고정지가조(B조)15례,남11례,녀4례;년령32～65세,평균49.1세,기록골절유합시간、병발증발생솔,병안조미국족과외과협회(AOFAS)적표준평개과관절공능,비교량조환자적료효.결과 소유환자술후획6～48개월(평균21개월)수방.골절유합시간:A조위3.5～12개월,평균(6.8±2.0)개월;B조위3～10개월(평균5.6±1.5)개월,량조비교차이유학의의(t=2.074,P=0.046).안조AOFAS표준진행평분:A조평균위(76.7±13.5)분,외고정기간병발증발생솔위34.8%(8/23);B조평균위(74.4±13.6)분,외고정기간병발증발생솔위40.0%(6/15).량조병발증발생솔여AOFAS평분비교차이무통계학의의(P>0.05).결론 단변외고정지가고정여쌍변조합식외고정지가고정균시치료경골원단골절적유효고정방식,재골절유합적시간방면,쌍변외고정지가교단변외고정지가구유우세.
Objective To compare unilateral and bilateral external fixators in the surgical treatment of fractures of distal tibia. Methods From August 2005 to February 2010, 38 patients with distal tibial fracture were treated surgically in our department. Of them, 23 (group A) were fixed with unilateral external fixator (16 males and 7 females with a mean age of 46. 5 years), and 15 (group B) fixed with bilateral external fixator (11 males and 4 females with a mean age of 49. 1 years) . All the patients were followed up periodically after operation. Time of fracture healing, complications, the American Orthopaedic Foot and Ankle Society (AOFAS) scores for the ankle were documented and analyzed statistically to compare the clinical outcomes of the 2 groups. Results The patients were followed up for 6 to 48 months (mean, 21 months).The mean time for clinical fracture union was 6. 8 ± 2. 0 months (3. S to 12. 0 months) for group A, and 5. 6 ± 1. 5 months (3 to 10 months) for group B. The complication rates during external fixation were 34. 8% (8/23) for group A and 40.0% (6/15) for group B. The AOFAS scores for functional recovery were 76. 7 ± 13. 5 for group A and 74. 4 ± 13. 6 for group B. Independent samples t test showed a significant difference ( P < 0. 05) between the 2 groups in time of clinical fracture union, but no significant difference (t = 2. 074, P = 0. 046) in complication rates and AOFAS scores. Conclusion Both unilateral and bilateral external fixators are effective for fixation of distal tibial fractures, but bilateral external fixators may be better in time of fracture healing.