腓骨内固定修复胫骨干远端1/3骨折:可明显改善胫骨外翻畸形及踝关节功能  

Fibular fixation for distal third tibia shaft fractures evidently improves tibial valgus and ankle function

作　　者：史瑞明[1,2] 冯世庆[1] 

机构地区：[1]天津医科大学总医院骨科,天津市300070 [2]海洋石油总医院骨科,天津市300452

出　　处：《中国组织工程研究》2015年第31期5004-5010,共7页Chinese Journal of Tissue Engineering Research

摘　　要：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。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 ofnbsp;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.

关 键 词：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 

分 类 号：R318[医药卫生—生物医学工程]