髓内钉结合阻挡螺钉修复胫骨远段骨折  

Intramedullary nail combined with blocking screws for treating distal tibial fractures

作　　者：侯靖钊[1] 张秋林[2] 包洪卫[1] 吴锦春[1] 唐昊[2] 汤旭日[3] 

机构地区：[1]靖江市人民医院,江苏省靖江市214500 [2]解放军第二军医大学附属长海医院脊柱外科,上海市200438 [3]浙江金华市中心医院,浙江省金华市321000

出　　处：《中国组织工程研究》2016年第31期4616-4622,共7页Chinese Journal of Tissue Engineering Research

基　　金：中国博士后科学基金二等资助(2015M571714);江苏省博士后日常资助课题~~

摘　　要：背景:对于胫骨远段骨折,采用切开复位钢板内固定、经皮微创钢板固定及髓内钉固定均是有效修复方法,但各有优缺点。目的:比较髓内钉结合阻挡螺钉技术与经皮微创钢板固定置入治疗胫骨远段骨折的疗效。方法:纳入51例胫骨远段骨折患者,按治疗方法分为2组,阻挡螺钉组(n=23)应用交锁髓内钉闭合穿钉结合阻挡螺钉置入固定,钢板固定组(。随访观察骨折愈合时间、胫骨功n=28)采用经皮微创钢板固定能恢复及并发症发生情况。结果与结论:随访8-32个月:(1)除钢板固定组1例骨不连外,其余患者均获得骨性愈合,阻挡螺钉组愈合时间为(4.6±1.7)个月,钢板固定组愈合时间为(6.9±2.3)个月,两组间愈合时间比较差异有显著性意义(P<0.05);(2)阻挡螺钉组胫骨功能恢复优良率为100%,显著高于钢板固定组的82%(P<0.05);(3)阻挡螺钉组、钢板固定组的不良事件发生率分别为13%、18%,组间比较差异无显著性意义(P>0.05);(4)结果表明,交锁髓内钉结合阻挡螺钉置入内固定修复胫骨远段骨折,可促进骨折愈合与关节功能恢复。BACKGROUND： For the treatment of distal tibial fractures, open reduction and plate fixation, minimally invasive percutaneous plate fixation and intramedullary nail fixation are effective, but each has advantages and disadvantages. OBJECTIVE： To compare the effects of intramedullary nail combined with blocking screws versus minimally invasive percutaneous plate fixation in treating distal tibial fractures. METHODS： Fifty-one cases of distal tibial fractures were divided into two groups. The blocking screw group （23 cases） was treated with closed reduction and internal fixation with interlocking nail combined with blocking screws. The plate fixation group （28 cases） was treated with minimally invasive percutaneous plate fixation. Fracture healing time, recovery of tibial function and complication occurrence were observed during follow-up. RESULTS AND CONCLUSION： All patients were followed up for 8 to 32 months. （1） Except one patient in the plate fixation group, the other patients had bony union. The healing time was （4.6±1.7） months in the blocking screw group and （6.9±2.3） months in the plate fixation group. Significant differences in healing time were detected between the two groups （P 〈 0.05）. （2） The excellent and good rate of tibial function recovery was significantly higher in the blocking screw group （100%） than in the plate fixation group （82%） （P 〈 0.05）. （3） No significant difference in the incidence of adverse events was determined between the blocking screw group （13%） and plate fixation group （18%） （P 〉 0.05）. （4） Results suggested that interlocking intramedultary nail combined with blocking screw fixation in the treatment of distal tibial fractures can promote fracture healing and joint function recovery.

关 键 词：胫骨骨折 骨折固定术 组织工程 骨科植入物 骨植入物 交锁髓内钉 阻挡钉 经皮微创接骨板固定技术 

分 类 号：R318[医药卫生—生物医学工程]