临床骨科杂志
臨床骨科雜誌
림상골과잡지
JOURNAL OF CLINICAL ORTHOPAEDICS
2014年
3期
332-335,336
,共5页
胫骨远端闭合骨折%内侧钢板%外侧钢板
脛骨遠耑閉閤骨摺%內側鋼闆%外側鋼闆
경골원단폐합골절%내측강판%외측강판
distal close tibial fractures%medial plate%lateral plate
目的：比较内侧钢板与外侧钢板内固定治疗胫骨远端闭合骨折的临床疗效。方法对56例胫骨远端闭合骨折患者应用钢板内固定治疗，根据钢板置于胫骨内侧或前外侧的不同分为内侧组（35例）和外侧组（21例）。比较两组患者手术时间、住院时间、骨折愈合时间、感染率、畸形愈合、延缓愈合等并发症情况。应用Johnner-Wruhs评分系统评价术后患肢功能，比较两组患者的疗效。结果骨折愈合时间：内侧组（17.57±3.27）周，外侧组（21.14±4.54）周，差异有统计学意义（P＜0.05）；内侧组中23例经皮微创锁定钢板内固定的骨折愈合时间为（15.22±4.67）周。骨折延缓愈合：内侧组1例，外侧组5例；畸形愈合：内侧组无，外侧组3例；Johnner-Wruhs评分优良率：内侧组88.57％（31/35），外侧组66.67％（14/21）；以上3项两组比较差异均有统计学意义（P＜0.05）。两组患者在手术时间、住院时间、感染率比较差异无统计学意义（P＞0.05）。结论内侧钢板和外侧钢板用于治疗胫骨远端闭合骨折均能取得较好的疗效，内侧钢板尤其是经皮微创锁定钢板内固定术在缩短骨折愈合时间和减少骨折畸形愈合、延缓愈合方面相对于外侧钢板有一定的优势。
目的：比較內側鋼闆與外側鋼闆內固定治療脛骨遠耑閉閤骨摺的臨床療效。方法對56例脛骨遠耑閉閤骨摺患者應用鋼闆內固定治療，根據鋼闆置于脛骨內側或前外側的不同分為內側組（35例）和外側組（21例）。比較兩組患者手術時間、住院時間、骨摺愈閤時間、感染率、畸形愈閤、延緩愈閤等併髮癥情況。應用Johnner-Wruhs評分繫統評價術後患肢功能，比較兩組患者的療效。結果骨摺愈閤時間：內側組（17.57±3.27）週，外側組（21.14±4.54）週，差異有統計學意義（P＜0.05）；內側組中23例經皮微創鎖定鋼闆內固定的骨摺愈閤時間為（15.22±4.67）週。骨摺延緩愈閤：內側組1例，外側組5例；畸形愈閤：內側組無，外側組3例；Johnner-Wruhs評分優良率：內側組88.57％（31/35），外側組66.67％（14/21）；以上3項兩組比較差異均有統計學意義（P＜0.05）。兩組患者在手術時間、住院時間、感染率比較差異無統計學意義（P＞0.05）。結論內側鋼闆和外側鋼闆用于治療脛骨遠耑閉閤骨摺均能取得較好的療效，內側鋼闆尤其是經皮微創鎖定鋼闆內固定術在縮短骨摺愈閤時間和減少骨摺畸形愈閤、延緩愈閤方麵相對于外側鋼闆有一定的優勢。
목적：비교내측강판여외측강판내고정치료경골원단폐합골절적림상료효。방법대56례경골원단폐합골절환자응용강판내고정치료，근거강판치우경골내측혹전외측적불동분위내측조（35례）화외측조（21례）。비교량조환자수술시간、주원시간、골절유합시간、감염솔、기형유합、연완유합등병발증정황。응용Johnner-Wruhs평분계통평개술후환지공능，비교량조환자적료효。결과골절유합시간：내측조（17.57±3.27）주，외측조（21.14±4.54）주，차이유통계학의의（P＜0.05）；내측조중23례경피미창쇄정강판내고정적골절유합시간위（15.22±4.67）주。골절연완유합：내측조1례，외측조5례；기형유합：내측조무，외측조3례；Johnner-Wruhs평분우량솔：내측조88.57％（31/35），외측조66.67％（14/21）；이상3항량조비교차이균유통계학의의（P＜0.05）。량조환자재수술시간、주원시간、감염솔비교차이무통계학의의（P＞0.05）。결론내측강판화외측강판용우치료경골원단폐합골절균능취득교호적료효，내측강판우기시경피미창쇄정강판내고정술재축단골절유합시간화감소골절기형유합、연완유합방면상대우외측강판유일정적우세。
Objective To compare the clinical results of medial plate and lateral plate internal fixation technique in treatment of distal closed tibial fractures.Methods 56 cases of distal close tibial fractures were divided into two groups according to the method of reduction.35 cases were treated with medial plate as medial group and 21 cases were treated with lateral plate as lateral group.Time of operation,time to union,hospital stay,infection rate,delayed union and malunion were compared between the two groups.Johner-Wruhs prognosis grades was introduced for func-tional evaluation.Results Fracture healing time after the operation in the medial group was(17.57 ±3.27)weeks, which was shorter than that in the lateral group (21.14 ±4.54)weeks,the differences were statistically significant(P<0.05).However,the healing time of 23 patients with minimally invasive plate osteosynthesis was(15.22 ±4.67) weeks.1 patients in the medial group and 5 in the lateral group showed delayed union;in the medial group none showed malunion,but 3 in the lateral group;the excellent rate of Johner-Wruhs prognosis grades in the lateral group 88.57%was better than those in the lateral group 66.67%,the differences were statistically significant(P<0.05). No significant difference was detected between the two groups on time of operation,time to union and infection rate(P>0.05 ).Conclusions Both medial plate and lateral plate are effective for treating distal close tibial fractures. However,medial group,especially minimally invasive plate osteosynthesis,has the advantage of reducing fracture healing time,malunion and delayed union.
