弹性髓内钉固定与石膏外固定治疗儿童胫骨干闭合性骨折的疗效对比  

Comparison of efficacy between fixation with elastic intramedullary nail and external fixation with plaster in children with closed tibia shaft fracture

作　　者：田培任 刘素乔 戴富强[1,2] 薛金伟[2] 

机构地区：[1]河北大学研究生学院,保定市071002 [2]河北大学附属医院骨科,保定市071000 [3]河北省晋州市人民医院急诊科,晋州市052260

出　　处：《广西医学》2016年第7期966-968,共3页Guangxi Medical Journal

摘　　要：目的对比弹性髓内钉固定与石膏外固定治疗儿童胫骨干闭合性骨折的临床疗效。方法选取胫骨干闭合性骨折儿童患者55例,随机分为保守治疗组27例和手术治疗组28例,保守治疗组采用闭合手法复位、管型石膏外固定治疗,手术治疗组采用闭合复位、弹性髓内钉内固定治疗,比较两组患者住院时间、骨折愈合时间、术后并发症、功能恢复情况等。结果手术治疗组患者住院时间为(8.3±3.5)d,短于保守治疗组的(18.2±4.8)d(P<0.05);手术治疗组、保守治疗组骨折愈合时间分别为(8.1±1.4)周、(8.7±3.1)周,两组比较,差异无统计学意义(P>0.05);术后手术治疗组、保守治疗组并发症发生率分别为7.14%、7.41%,两组比较,差异无统计学意义(P>0.05);手术治疗组、保守治疗组优良率分别为92.86%、92.59%,两组比较,差异无统计学意义(P>0.05);保守治疗组总体经济费用为(4 600.96±865.78)元,少于手术治疗组的(12 528.12±1 432.86)元(P<0.05)。结论弹性髓内钉手术内固定与管型石膏外固定治疗儿童胫骨干闭合骨折,均能获得满意的临床疗效,应根据患者具体情况合理选择治疗方法。Objective To compare the clinical efficacy between fixation with elastic intramedullary nail and external fixation with plaster in children with closed tibia shaft fracture. Methods A total of 55 children with closed tibia shaft fracture were randomly divided into conservative therapy group（ n = 27） and surgical therapy group（ n = 28）. Closed manipulative reduction and external fixation with plaster cast were conducted in the conservative therapy group,and closed reduction and fixation with elastic intramedullary nail in the surgical therapy group.The hospital stay,time for fracture healing,postoperative complications and functional recovery were compared between two groups. Results The hospital stay of the surgical therapy group was（ 8. 3 ± 3. 5） days,and was shorter than that of the conservative therapy group[（ 18. 2 ± 4. 8） days,P〈0. 05]. The times for fracture healing in the surgical therapy group and conservative therapy group were（ 8. 1 ± 1. 4） weeks and（ 8. 7 ± 3. 1）weeks,but no statistical significant was found（ P〉0. 05）. The incidences of postoperative complications in the surgical therapy group and conservative therapy group were 7. 14% and 7. 41% respectively,but no statistical significant was found（ P〉0. 05）. The surgical excellent and good rate in the surgical therapy group and conservative therapy group were 92. 86% and 92. 59% respectively,but no statistical significant was found（ P〉0. 05）. The total cost of the conservative therapy group was（ 4 600. 96 ± 865. 78） yuan,and was less than that of the surgical therapy group[（ 12 528. 12 ± 1 432. 86） yuan,P〈0. 05]. Conclusion For children with closed tibia shaft fracture,either surgical internal fixation with elastic intramedullary nail or external fixation with plaster cast can obtain a satisfied clinical efficacy. And the therapy plan should be chosen according to the specific conditions of patients.

关 键 词：胫骨干骨折 弹性髓内钉 管型石膏 生物学固定 儿童 

分 类 号：R683.42[医药卫生—骨科学]