外固定支架术与经皮微创钢板内固定术治疗胫腓骨骨折的临床效果比较  

Comparison of clinical effect of external fixation and percutaneous minimally invasive plate fixation in the treatment of tibial and fibula fractures

作　　者：刘承涛[1] 赵锦阳 王晓光[1] 唐豪[2] 

机构地区：[1]山东省文登整骨医院,山东文登264400 [2]解放军第三军医大学学员七营,重庆400038

出　　处：《中国当代医药》2016年第10期99-101,104,共4页China Modern Medicine

摘　　要：目的比较外固定支架术与经皮微创钢板内固定术治疗胫腓骨骨折的临床疗效及安全性。方法收集2010年1月~2014年6月在我院接受治疗的胫腓骨开放性骨折患者100例,根据随机数字表法将患者分为微创经皮钢板接骨术组（A组）和外固定支架组（B组）,各组50例。A组行微创经皮钢板接骨术;B组行外固定支架术。比较两组的术中指标（手术时间、失血量）、术后指标（肿胀消退时间、骨折愈合时间）及相关并发症（切口感染、水肿、骨不连、骨髓炎、神经损伤）发生情况及临床疗效。结果 B组手术时间、术后骨折愈合时间明显长于A组（P〈0.05）。两组的切口感染、水肿、骨不连、骨髓炎、神经损伤发生率及总并发症发生率比较,差异无统计学意义（P〉0.05）。A组的末次随访临床疗效明显优于B组（P〈0.05）,A组优良率明显高于B组（P〈0.05）。结论微创经皮钢板接骨术治疗胫腓骨骨折的临床疗效略优于外固定支架术,其手术时间短、骨折愈合快,而外固定支架治疗感染发生率较低。Objective To compare the clinical curative efficacy and safety of external fixation and percutaneous minimally invasive plate fixation in the treatment of tibial and fibula fractures. Methods 100 patients with open tibiofibular fractures who were treated in our hospital from January 2010 to June 2014 were selected.According to the random number table method,they were divided into minimally invasive by percutaneous plate osteosynthesis group（group A） and external fixator group（group B）,with 50 patients in each group.Group A were done minimally invasive per cutaneous plate osteosynthesis,and group B were done external fixation,the operation indicators（operation time,blood loss）,postoperative indicators（swelling fade and fracture healing time）,the occurring situation of related complications（wound infection,edema,bone is not even,osteomyelitis,nerve injury） and the clinical efficacy were compared between the two groups. Results The operation time and fracture healing time in group B was significantly longer than that of group A respectively（P〈0.05）.The occurring incidence of incision infection,edema,bone nonunion,osteomyelitis,nerve injury and total complication incidence had no significant difference between the two groups（P〉0.05）.The clinical efficacy at last follow-up of group A was significantly better than that in group B（P〈0.05）,and the excellent rate in group A was significantly higher than that in group B（P〈0.05）. Conclusion The clinical efficacy of treating tibial and fibula fractures by minimally invasive percutaneous plate osteosynthesis is slightly better than that by fixed bracket operation,it can shorten operation time and fracture healing time,but external fixation can reduce the incidence of infection.

关 键 词：外固定支架 经皮微创钢板内固定 胫腓骨骨折 

分 类 号：R687.3[医药卫生—骨科学]