重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2013年
29期
3491-3492,3495
,共3页
胫骨干骨折%交锁髓内钉%动力化
脛骨榦骨摺%交鎖髓內釘%動力化
경골간골절%교쇄수내정%동력화
tibial shaft fracture%interlocking intramedullary nail%dynamization
目的：对比分析在骨折间隙小于2．0mm的情况下，交锁髓内钉进行动力化与未进行动力化治疗胫骨干骨折的临床疗效。方法选取该院于2009年1月至2012年12月收治的157例采用带动力孔的交锁髓内钉闭合复位固定治疗胫骨干骨折且主要骨折间隙小于2．0mm的患者，将其中同意动力化的87例患者分入动力化组并进行髓内钉的动力化，其余70例患者未进行动力化，随访并比较两组的治疗效果。结果动力化组与未动力化组愈合时间的比较差异无统计学意义[（177．4±10．3）dvs．（179．7±9．6）d，t＝1．444，P＞0．05]；内固定术后16周，动力化组的VAS评分明显高于未动力化组[（4．1±0．6）vs．（2．3±0．8），t＝16．100，P＜0．05）]；动力化组术后膝关节疼痛率要明显高于未动力化组（28．7％vs．12．9％，χ2＝5．764，P＜0．05）。结论采用闭合复位交锁髓内钉内固定治疗胫骨干骨折，当主要骨折间隙小于2．0mm时，髓内钉动力化并不比未动力化更有优势。
目的：對比分析在骨摺間隙小于2．0mm的情況下，交鎖髓內釘進行動力化與未進行動力化治療脛骨榦骨摺的臨床療效。方法選取該院于2009年1月至2012年12月收治的157例採用帶動力孔的交鎖髓內釘閉閤複位固定治療脛骨榦骨摺且主要骨摺間隙小于2．0mm的患者，將其中同意動力化的87例患者分入動力化組併進行髓內釘的動力化，其餘70例患者未進行動力化，隨訪併比較兩組的治療效果。結果動力化組與未動力化組愈閤時間的比較差異無統計學意義[（177．4±10．3）dvs．（179．7±9．6）d，t＝1．444，P＞0．05]；內固定術後16週，動力化組的VAS評分明顯高于未動力化組[（4．1±0．6）vs．（2．3±0．8），t＝16．100，P＜0．05）]；動力化組術後膝關節疼痛率要明顯高于未動力化組（28．7％vs．12．9％，χ2＝5．764，P＜0．05）。結論採用閉閤複位交鎖髓內釘內固定治療脛骨榦骨摺，噹主要骨摺間隙小于2．0mm時，髓內釘動力化併不比未動力化更有優勢。
목적：대비분석재골절간극소우2．0mm적정황하，교쇄수내정진행동력화여미진행동력화치료경골간골절적림상료효。방법선취해원우2009년1월지2012년12월수치적157례채용대동력공적교쇄수내정폐합복위고정치료경골간골절차주요골절간극소우2．0mm적환자，장기중동의동력화적87례환자분입동력화조병진행수내정적동력화，기여70례환자미진행동력화，수방병비교량조적치료효과。결과동력화조여미동력화조유합시간적비교차이무통계학의의[（177．4±10．3）dvs．（179．7±9．6）d，t＝1．444，P＞0．05]；내고정술후16주，동력화조적VAS평분명현고우미동력화조[（4．1±0．6）vs．（2．3±0．8），t＝16．100，P＜0．05）]；동력화조술후슬관절동통솔요명현고우미동력화조（28．7％vs．12．9％，χ2＝5．764，P＜0．05）。결론채용폐합복위교쇄수내정내고정치료경골간골절，당주요골절간극소우2．0mm시，수내정동력화병불비미동력화경유우세。
Objective To prospectively compare the clinical outcome of dynamization and non-dynamization of interlocking intr-amedullary nail on union of tibial shaft fractures (fracture gap<2 .0 mm) .Methods From January 2009 to December 2012 ,157 pa-tients with tibial shaft fractures (fracture gap<2 .0 mm) were treated in this department with internal fixation underwent static in-terlocking intramedullary nails .87 cases who accepted early dynamization were divided into the dynamization group while 70 cases who didn′t accept dynamization were divided into the non-dynamic group .Patients were followed up and the clinical outcome of two groups were compared .Results The difference of mean healing time between the two groups was not statistically significant [(177 .4 ± 10 .3)d vs .(179 .7 ± 9 .6)d ,t=1 .444 ,P>0 .05];16 weeks after internal fixation surgery ,VAS score of the dynamization group was statistically higher than that of the non-dynamization group [(4 .1 ± 0 .6) vs .(2 .3 ± 0 .8) ,t=16 .100 ,P<0 .05];the knee pain rate of the dynamization group was statistically higher than that of the non-dynamization group (28 .7% vs .12 .9% ,χ2 =5 .764 ,P<0 .05) .Conclusion When treating tibial shaft fractures with closed reduction and intramedullary nail fixation ,the main fracture gap<2 .0 mm ,early dynamization didn′t have any advantage .
