中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2015年
31期
5004-5010
,共7页
植入物%骨植入物%胫腓骨骨折%远端1/3骨折%腓骨固定%内固定%胫骨干%骨折愈合%外翻畸形%踝关节功能
植入物%骨植入物%脛腓骨骨摺%遠耑1/3骨摺%腓骨固定%內固定%脛骨榦%骨摺愈閤%外翻畸形%踝關節功能
식입물%골식입물%경비골골절%원단1/3골절%비골고정%내고정%경골간%골절유합%외번기형%과관절공능
Tibial Fractures%Fibula%Fracture Fixation%Fracture Healing
背景：胫腓骨干骨折是四肢骨干骨折中最常见的骨折类型，对于腓骨固定在胫骨干远端骨折的临床意义，一直存在争论，各研究报道也不尽相同。目的：探讨腓骨内固定在胫骨干远端1/3骨折修复中的临床意义。方法：回顾性分析2006年1月至2010年3月于海洋石油总医院骨科治疗的64例胫骨干远端1/3骨折患者的临床资料，根据是否固定腓骨分为两组，其中腓骨固定组36例，腓骨非固定组28例。比较两组患者的骨折愈合率、骨折愈合时间及胫骨外翻角，根据Merchant-Dietz标准评估对比两组的踝关节活动度及踝关节功能评分。结果与结论：两组患者的骨折愈合率、骨折愈合时间、踝关节活动度差异无显著性意义；腓骨固定组的胫骨外翻角(5.42±1.16)°小于腓骨非固定组(7.54±1.90)°，差异有显著性意义(P=0.006)；腓骨固定组踝关节功能评分(93.58±0.97)分高于腓骨非固定组(90.57±3.92)分，差异有显著性意义(P=0.000)。腓骨固定组中3例伤口浅部感染，抗炎换药后愈合良好。提示在胫骨干远端1/3骨折治疗中，腓骨内固定可明显缩小胫骨外翻角，改善踝关节功能。
揹景：脛腓骨榦骨摺是四肢骨榦骨摺中最常見的骨摺類型，對于腓骨固定在脛骨榦遠耑骨摺的臨床意義，一直存在爭論，各研究報道也不儘相同。目的：探討腓骨內固定在脛骨榦遠耑1/3骨摺脩複中的臨床意義。方法：迴顧性分析2006年1月至2010年3月于海洋石油總醫院骨科治療的64例脛骨榦遠耑1/3骨摺患者的臨床資料，根據是否固定腓骨分為兩組，其中腓骨固定組36例，腓骨非固定組28例。比較兩組患者的骨摺愈閤率、骨摺愈閤時間及脛骨外翻角，根據Merchant-Dietz標準評估對比兩組的踝關節活動度及踝關節功能評分。結果與結論：兩組患者的骨摺愈閤率、骨摺愈閤時間、踝關節活動度差異無顯著性意義；腓骨固定組的脛骨外翻角(5.42±1.16)°小于腓骨非固定組(7.54±1.90)°，差異有顯著性意義(P=0.006)；腓骨固定組踝關節功能評分(93.58±0.97)分高于腓骨非固定組(90.57±3.92)分，差異有顯著性意義(P=0.000)。腓骨固定組中3例傷口淺部感染，抗炎換藥後愈閤良好。提示在脛骨榦遠耑1/3骨摺治療中，腓骨內固定可明顯縮小脛骨外翻角，改善踝關節功能。
배경：경비골간골절시사지골간골절중최상견적골절류형，대우비골고정재경골간원단골절적림상의의，일직존재쟁론，각연구보도야불진상동。목적：탐토비골내고정재경골간원단1/3골절수복중적림상의의。방법：회고성분석2006년1월지2010년3월우해양석유총의원골과치료적64례경골간원단1/3골절환자적림상자료，근거시부고정비골분위량조，기중비골고정조36례，비골비고정조28례。비교량조환자적골절유합솔、골절유합시간급경골외번각，근거Merchant-Dietz표준평고대비량조적과관절활동도급과관절공능평분。결과여결론：량조환자적골절유합솔、골절유합시간、과관절활동도차이무현저성의의；비골고정조적경골외번각(5.42±1.16)°소우비골비고정조(7.54±1.90)°，차이유현저성의의(P=0.006)；비골고정조과관절공능평분(93.58±0.97)분고우비골비고정조(90.57±3.92)분，차이유현저성의의(P=0.000)。비골고정조중3례상구천부감염，항염환약후유합량호。제시재경골간원단1/3골절치료중，비골내고정가명현축소경골외번각，개선과관절공능。
BACKGROUND:Fractures of shafts of the tibia and fibula are the most common diaphyseal fractures among al long bones. The clinical significance of fibula fixation in treatment of distal third shaft fractures is controversial, and the studies are also different. OBJECTIVE:To explore the clinical significance of fibular fixation in treatment of distal third tibia shaft fractures. METHODS:A retrospective review has been performed on the clinical data of sixty-four cases with distal third tibia shaft fracture in Department of Orthopedics, China National Offshore Oil Corporation General Hospital from January 2006 to March 2010. Al cases were divided into two groups based on whether the fibula was fixed or not: fibula fixation group (n=36) and fibula non-fixation group (n=28). Union rate of fracture, bone union time and tibial valgus angle were compared between the two groups. According to Merchant-Dietz criteria, the ankle range of motion and ankle evaluation score were evaluated and compared between the two groups. RESULTS AND CONCLUSION: No significant difference in union rate of fracture, bone union time and ankle range of motion was detected between two groups. Tibial valgus angle was smaler in the fibula fixation group (5.42±1.16)° than in the fibula non-fixation group (7.54±1.90)°(P=0.006). Ankle function score was higher in the fibula fixation group (93.58±0.97) than in the fibula non-fixation group (90.57±3.92) (P=0.000). Three cases in the fibula fixation group suffered from superficial wound infection, and achieved good healing after treatment of anti-infection and changing dresses. Above results verify that fibular fixation can reduce tibial valgus angle and improve ankle joint function in treatment of distal third tibia fractures.
