微创经皮钢板与带锁髓内钉治疗胫骨骨折的疗效分析  

A comparison of results between minimally invasive percutaneous plate and interlocking intramedullary nail for treatment of tibia fracture

作　　者：程继武[1] 林博文[1] 肖德明[1] 黎伟凡 谢伟平 麦汉溪[1] 张晓明 潘晓华[1] 郑晔 

机构地区：[1]深圳市人民医院骨科.暨南大学医学院附属第二医院,深圳518020

出　　处：《中原医刊》2006年第1期13-15,共3页Central Plains Medical Journal

摘　　要：目的探讨微创经皮钢板与带锁髓内钉治疗胫骨骨折的临床疗效。方法69例胫骨骨折患者用两种内固定方法治疗。胫骨远、近端骨干骨折6例，成人多段骨折4例。儿童中段骨折3例，共13例，因不适合带锁髓内钉治疗而选择微创经皮钢板接骨术。其余56例被随机分成两组，分别行微创经皮钢板接骨术和带锁髓内钉治疗。全部病例获得随诊，时间12—24个月，平均15个月。从手术时间、手术出血量、平均住院日、骨折愈合时间和并发症5个方面进行比较分析。结果微创经皮钢板接骨术与带锁髓内钉治疗胫骨骨折相比，手术时间、术中出血量、住院时间、愈合时间及并发症差异无统计学意义（P〉0．05）。结论微创经皮钢板接骨术与带锁髓内钉治疗胫骨骨折都能减少对骨折处血运的干扰，提高骨折愈合率，减少并发症。掌握好手术指征，是治疗胫骨骨折的两种较理想方法。Objective To discuss the results of treating tibia fracture by minimally invasive percutaneous plate osteosynthesis and interlocking intramedullary nail. Methods Sixty - nine cases of tibia fracture were treated with two kinds of internal fixations. There were 6 proximal or distal metaphyseal fractures and 4 segmental fractures in adults and 3 mid - shaft fractures in adolescents who still had an open physis. These fractures which would be difficult for treatment by interlocking intramedullary nail that stabilized with mini - invasive percutaneous plate. Other cases of 56 were divided into two groups randomly. One group （26 cases） were followed by minimally invasive percutaneous plate osteosynthesis, the other group of 30 cases by interlocking intramedullary nail. All the patients were followed up for 12 - 24 months after operation（ average 15 months）. Five factors including surgery time, intraoperation bleeding,inhospital time, healing analyse the two kinds of internal fracture fixations. Results precutaneous plate osteosynthesis was as good as interlocking time and complications were studied statisfically to Treatment of tibia fracture with minimally invasive intramedullary nail. There were no significant difference between two groups in surgery time,intraoperation bleeding, in hospital time, healing time and complications. Conclusion Treatment of tibia fracture with minimally invasive plate osteosynthesis and interlocking intramedullary nail both can reduce disturbing vascularization of bone fragment,accelerate bone healing and reduce complications, and they are two ideal therapies as long as appropriate indication being selected.

关 键 词：微创经皮钢板接骨术 带锁髓内钉 胫骨骨折 内固定 

分 类 号：R687.3[医药卫生—骨科学]