中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
8期
37-40
,共4页
胫骨骨折%带锁髓内钉%内固定%加压钢板
脛骨骨摺%帶鎖髓內釘%內固定%加壓鋼闆
경골골절%대쇄수내정%내고정%가압강판
Tibial fractures%Interlocking intramedullary nail%Internal fixation%Dynamic compression plate
目的 比较带锁髓内钉和加压钢板内固定两种方法治疗胫骨干骨折的疗效.方法 收集137例胫骨干骨折患者,按照入院后手术治疗方法不同分为闭合复位带锁髓内钉内固定72例(髓内钉组),共79处骨折;切开复位钛板螺钉内固定65例(钢板组),共70处骨折,比较两组治疗效果、愈合优良率、术后功能评分以及并发症发生情况.结果 所有患者术后均获随访,平均随访时间21.4个月.髓内钉组患者术后出现骨痂时间、患肢负重时间、骨折愈合时间以及术后取内固定物时间均明显少于钢板组[(2.36±0.46)个月比(3.12±0.57)个月、(2.42±0.51)个月比(3.14±0.63)个月、(7.65±1.29)个月比(9.33±1.54)个月、(12.64±3.76)个月比(16.38±3.15)个月],差异有统计学意义(P＜0.05).髓内钉组治疗优良率为97.5％(77H9),钢板组为92.9％(65/70),两组比较差异无统计学意义(r=1.76,P＞0.05).髓内钉组患者术后总并发症发生率显著低于钢板组[2.5％(2/79)比12.9％(9/70)],差异有统计学意义(P＜0.05).结论 带锁髓内钉内固定治疗胫骨干骨折较加压钢板内固定手术愈合率更高,临床疗效更好,手术并发症发生率更低.
目的 比較帶鎖髓內釘和加壓鋼闆內固定兩種方法治療脛骨榦骨摺的療效.方法 收集137例脛骨榦骨摺患者,按照入院後手術治療方法不同分為閉閤複位帶鎖髓內釘內固定72例(髓內釘組),共79處骨摺;切開複位鈦闆螺釘內固定65例(鋼闆組),共70處骨摺,比較兩組治療效果、愈閤優良率、術後功能評分以及併髮癥髮生情況.結果 所有患者術後均穫隨訪,平均隨訪時間21.4箇月.髓內釘組患者術後齣現骨痂時間、患肢負重時間、骨摺愈閤時間以及術後取內固定物時間均明顯少于鋼闆組[(2.36±0.46)箇月比(3.12±0.57)箇月、(2.42±0.51)箇月比(3.14±0.63)箇月、(7.65±1.29)箇月比(9.33±1.54)箇月、(12.64±3.76)箇月比(16.38±3.15)箇月],差異有統計學意義(P＜0.05).髓內釘組治療優良率為97.5％(77H9),鋼闆組為92.9％(65/70),兩組比較差異無統計學意義(r=1.76,P＞0.05).髓內釘組患者術後總併髮癥髮生率顯著低于鋼闆組[2.5％(2/79)比12.9％(9/70)],差異有統計學意義(P＜0.05).結論 帶鎖髓內釘內固定治療脛骨榦骨摺較加壓鋼闆內固定手術愈閤率更高,臨床療效更好,手術併髮癥髮生率更低.
목적 비교대쇄수내정화가압강판내고정량충방법치료경골간골절적료효.방법 수집137례경골간골절환자,안조입원후수술치료방법불동분위폐합복위대쇄수내정내고정72례(수내정조),공79처골절;절개복위태판라정내고정65례(강판조),공70처골절,비교량조치료효과、유합우량솔、술후공능평분이급병발증발생정황.결과 소유환자술후균획수방,평균수방시간21.4개월.수내정조환자술후출현골가시간、환지부중시간、골절유합시간이급술후취내고정물시간균명현소우강판조[(2.36±0.46)개월비(3.12±0.57)개월、(2.42±0.51)개월비(3.14±0.63)개월、(7.65±1.29)개월비(9.33±1.54)개월、(12.64±3.76)개월비(16.38±3.15)개월],차이유통계학의의(P＜0.05).수내정조치료우량솔위97.5％(77H9),강판조위92.9％(65/70),량조비교차이무통계학의의(r=1.76,P＞0.05).수내정조환자술후총병발증발생솔현저저우강판조[2.5％(2/79)비12.9％(9/70)],차이유통계학의의(P＜0.05).결론 대쇄수내정내고정치료경골간골절교가압강판내고정수술유합솔경고,림상료효경호,수술병발증발생솔경저.
Objective To investigate the difference of efficacy of interlocking nails and dynamic compression plate in tibial shaft fractures.Methods The clinical data of 137 cases with tibial shaft fractures were reviewed retrospectively.They were divided into two groups according to the various treatments which included interlocking nails group(72 cases with 79 fractures) and dynamic compression plate group(65 cases with 70 fractures).The efficacy,healing fineness rate,function score after operation and complications were compared.Results After operation,the patients were followed up 21.4 months on average.The postoperative callus time,weight-bearing limb time,healing time and postoperative fixation time taken in interlocking nails group was shorter than that in dynamic compression plate group [(2.36 ± 0.46) months vs.(3.12 ± 0.57) months,(2.42 ± 0.51) months vs.(3.14 ± 0.63) months,(7.65 ± 1.29) months vs.(9.33 ±1.54) months,(12.64 ± 3.76) months vs.(16.38 ± 3.15) months],and there was significant difference (P＜ 0.05).The healing fineness rate was 97.5％(77/79) in interlocking nails group,and 92.9％(65/70) in dynamic compression plate group,and there was nosignificant difference (x2 =1.76,P ＞0.05).The incidence of comphcations in interlocking nails group was higher than that in dynamic compression plate group[25％(2H9) vs.12.9％(9H0)],and there was significant difference(P ＜ 0.05).Condmions Interlocking nails have better biomechanical features with high union rate,low infective rate and good recovery of joint function.The clinical result of interlocking nails for the tibial shaft fractures is also better than that of dynamic compression plate.
