交锁髓内钉与LCP内固定治疗胫骨远端骨折的放射学及临床疗效比较  

Comparison of Results of Radiology and Clinical Effect with Methods of Intramedullary Nailing and LCP in Treating Distal Tibial Fractures

作　　者：楚宇鹏[1] 孔建中[1] 牟暇平[1] 水小龙[1] 翁益民[1] 郭晓山[1] 陈华[1] 

机构地区：[1]温州医学院附属第二医院骨科医院,浙江省温州市325027

出　　处：《中国骨与关节损伤杂志》2010年第12期1080-1082,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的比较交锁髓内钉与锁定加压钢板(LCP)内固定结合MIPPO技术治疗胫骨远端骨折的放射学及临床疗效,探讨胫骨远端骨折的内固定选择。方法对117例胫骨骨折,分别接受交锁髓内钉和锁定加压钢板结合MIPPO技术治疗胫骨远端骨折,髓内组48例和LCP组69例。观察放射学及踝关节功能"美国足部和踝部矫形外科协会的踝部损伤评定量表"(AOFAS)评分。结果随访18～42个月,平均26.5个月,117例中102例骨折愈合,出现延迟愈合12例,骨不连3例。放射学结果根据Johner-Wruhs评分:满意101例(86.3%),不满意16例(13.7%)。经放射学比较,可见LCP组的满意率高于髓内钉组,差别有统计学意义(P<0.05)。AOFAS评分:髓内钉组平均82.47分,LCP组平均85.24分,两组评分差异无统计学意义(P>0.05)。结论交锁髓内钉和LCP都是治疗胫骨远端骨折的有效方法,但从放射学表现看,LCP效果较优,尤其在靠近胫骨远端关节面的骨折,其具有更好的固定效果。Objective To compare the radiographic and functional outcomes of IM nailing and LCP in treatment of distal tibial fractures.Methods One hundred and seventeen cases of distal tibial fracture were managed with IM nailing and LCP.The data of two groups were collected for statistical analysis of the plain radiographs results and the assessment of foot and ankle outcome using AOFAS.Results All patients were followed up from 18～42 months with an average of 26.5 months,and bony union was achived in 102 patients,there was 12 cases of delayed union and 3 cases of developed into nonunion.The satisfactory radiologic outcomes were respectively 39 cases and 62 cases between two methods.The differences of radiologic outcomes between IM nailing and LCP were of statistical significance（P 〈0.05）.According to AOFAS scoring,the outcomes were respectively 82.47 scores and 85.24 scores between two groups,the differences were of no statically significance（P 〉0.05）.Conclusion IM nailing and LCP are good methds in treating distal tibial fractures,but LCP shows better results in radiologic outcomes especially in treating the fractures that close extra-articular fractures.

关 键 词：交锁髓内钉 LCP MIPPO 胫骨远端 

分 类 号：R683.42[医药卫生—骨科学]