三种固定方式治疗胫腓骨骨折的临床疗效比较  

作　　者：魏伟生[1] 李新发[1] 肖东民[1] 

机构地区：[1]湖南省永州市人民医院骨科,425006

出　　处：《医学信息（下旬刊）》2011年第2期37-38,共2页Medical information

摘　　要：目的：比较三种固定方法治疗胫腓骨骨折的疗效。方法：从2005年12月～2009年10月270例病人随机分为三组，分别采用外固定支架、AO加压钢板、交锁髓内钉治疗胫腓骨骨折患者，对比其疗效。结果：随访12～18个月，平均16个月。交锁髓内钉组96例，优72例、良20例、差4例，优良率95．8％；加压钢板组98例，优35例，良24例，差39例，优良率60．2％；外固定支架组76例，优38例，良12，差26例，优良率65．7％。外固定支架组与加压钢板组疗效间差别无统计学意义（P〉0.05），外固定支架组与交锁髓内钉组疗效间差别有统计学意义（P〈0．05），加压钢板组与交锁髓内钉组疗效间差剐有统计学意义（P〈0．05）。结论：交锁髓内钉可广泛应用于闭合性胫腓骨复杂骨折，且优于AO钢板及外固定支架，术后骨折愈合较为理想。AO钢板应慎用于胫骨中下1／3段复杂闭合性骨折。外固定支架时开放性骨折是上述方法的补充。Objective To compare therapeutic effect of tibial and fibular fracture on the use of three different fixation methods. Methods From December 2005 to November 2009,270 eases of tibial and fibular fracture received treatment of different methods were analyzed with external fixator . AO compressed steel plats, interlocking nail retrospectively. Results All eases were followed--up for 12- 18 months, average followed--up period were 16 months after operation, interlocking hail in the treatment of 96 eases,the gifted72 eases,good in 20 cases.,poor 4 cases,excellent rate of 95. 8 %. AO compressed steel plats in the treatment of 98 cases, the gifted 35cases, good in 24 eases , poor 39cases, excellent rate of 60.2 %. External fixation in the treatment of 76 cases,the gifted 38 eases,good in 12 cases ,poor 26 cases,excellent rate of 65.7%. External fixation and AO compressed steel plats in therapeutic effect of tibial and fibular fracture have not significant difference（P〉0.05）. External fixation and interlocking nail have significant difference. AO compressed steel plats and interlocking nail have significant difference（P〈0.05）. Conclusion The intramedulIary interlocking nail was considered as an effeetive means of treatment of tibial and fibulal fracture ,with little hurt of operation,good anatomy reposition,high rate of fracture healing. It should be careful that the fracture of 1/3 middle and lower segment of the tibia was treated by AO plate. The exterior external fixator were an additional mean in treating opened fracture.

关 键 词：胫腓骨骨折 外固定支架 AO加压钢板 交锁髓内钉 疗效 

分 类 号：R683.4[医药卫生—骨科学]