复杂性胫腓骨骨折的三种微创手术方法比较  

Comparison of 3 Minimally Invasive Operative Methods for Treatment of Complicate Tibiofibular Fracture

作　　者：余伟宏 雷刚刚[2] 邹健 

机构地区：[1]东莞市中医院骨科,广东东莞523005 [2]南昌大学第一附属医院骨科,南昌330006

出　　处：《实用临床医学（江西）》2008年第12期55-58,共4页Practical Clinical Medicine

摘　　要：目的探讨经皮锁定桥接钢板技术、带锁髓内钉技术、AO外固定架技术在复杂性胫腓骨骨折治疗中的疗效。方法将61例胫腓骨复杂性骨折患者根据手术方式不同分为3组:带锁髓内钉组18例,锁定钢板加压组23例,AO外固定组20例。分别对3组手术时间、术中出血量、手术透视时间、术后肿胀消退时间、住院时间、骨折愈合时间、术后并发症率、术后疗效进行比较。结果3组的手术时间、手术透视时间、住院时间、24周骨折愈合、术后并发症比较差异无统计学意义(P>0.05);锁定钢板组及AO外固定组术中出血量、术后肿胀消退时间、12周骨折愈合与带锁髓内钉组比较,差异有统计学意义(P<0.05或P<0.01)。结论经皮锁定桥接钢板技术、带锁髓内钉、AO外固定架都是治疗复杂性胫骨骨折的好方法,经皮锁定桥接钢板技术和AO外固定架在治疗上具有明显的优势,降低了对骨折处血运的干扰,减少了术中出血量,减轻了术后患腿肿胀程度,促进了骨折愈合。Objective To discuss the results of treating complicate tibiofibular fracture by percutaneous locking bridging-plate osteosynthesis,interlocking intramedullary nail and AO external fixator,to provide the data for the clinical application.Methods Sixty-one patients who suffered from complicate tibiofibular fracture were divided into three groups at random.Combining indirect redution,treated by interlocking intramedullary nail（n=18）;percutaneous locking bridging-plate osteosynthesis（n=23）;AO external fixator（n=20）.Compare them with surgery time,intraoperation beeding,fluoroscopical time,time of well-subsidese,in-hospital time,fracture union rate of 12 and 24 weeks,complications rate,postoperative therapeutic effect,etc.Results There were not significant difference in surgery time,fluoroscopical time in operation,the in-hospital time,fracture union rate of 24 weeks,the rate of complications postoperative,the postoperative therapeutic effect（P〉0.05）.There are significant difference in the intraoperation bleeding,time of well-subsidese and fracture union rate of 12 weeks（P〈0.05 or P〈0.01）.Conclusion Treatment of complicate tibiofibular fracture with the percutaneous locking bridging-plate osteosynthesis,interlocking intramedullary nail and AO external fixator are all ideal therapies.It is obvious that the percutaneous locking bridging-plate osteosynthesis and AO external fixator in the complicate tibiofibular fractures have many advantages,and it can reduce disturbing vascularization of borne fragment,decrease intraoperation beeding and the time of well-subsideise,accelerate bone healing.

关 键 词：胫腓骨骨折 骨折固定术 锁定加压钢板 带锁髓内钉 外固定架 

分 类 号：R683.42[医药卫生—骨科学]