闭合复位髓内钉与切开复位钢板固定治疗胫腓骨多段骨折的疗效比较  

作　　者：王瑾[1] 徐卫星[1] 黄凯[1] 

机构地区：[1]浙江省立同德医院,310012

出　　处：《浙江临床医学》2020年第4期535-537,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探究髓内钉微创治疗胫腓骨多段骨折对围手术期指标、并发症及功能评分的影响.方法选取2011年9月至2018年9月收治的胫腓骨多段骨折患者100例为观察对象,根据手术方式分为观察组(50例)和对照组(50例),观察组采取闭合复位微创交锁髓内钉内固定术,对照组采取切开复位普通钢板内固定术.比较两组患者手术时间、切口长度、术中出血量、住院时间、骨折愈合时间、术后并发症发生率及踝关节功能评分.结果观察组患者手术时间、术后引流时间、住院时间及骨折愈合时间均短于对照组,术中出血量较对照组少,切口较对照组短,差异均有统计学意义(P<0.05).观察组患者术后1、3、6个月Mazur评分及踝关节功能优良率均高于对照组(P<0.05).术后6个月,观察组与对照组临床总有效率分别为92.0%和68.0%,差异有统计学意义(P<0.05).观察组与对照组术后并发症发生率分别为10.0%和28.0%,差异有统计学意义(P<0.05).治疗前两组膝关节活动度(伸、屈)无明显差异,治疗后观察组均高于对照组,差异有统计学意义(P<0.05).结论闭合复位交锁髓内钉骨折较传统开放复位钢板固定具有操作时间短、创伤小、骨折愈合快、手术并发症少等优点.Objective To explore the effect of intramedullary nail minimally invasive treatment on perioperative index,complication and function score of tibia and fibula fracture.Methods From September 2011 to September 2018,From September 2011 to September 2018,100 patients with tibial and fibular multiple fractures were selected as the observation objects.According to the operation mode,they were divided into the observation group(50 cases)and the control group(50 cases).The observation group was treated with closed reduction and minimally invasive interlocking intramedullary nail internal fixation,while the control group was treated with open reduction and common plate internal fixation.The operarion time,incision length,intraoperative blood loss,hospital time,fracture healing time,postoperative complication rate and ankle function score were compared between the two groups.Results The observation group of patients with operation time,postoperative drainage time,hospitalization time and fracture healing time were shorter than the control group,intraoperative blood loss less than the control group,incision was the shorter of the control group,the difference had statistical significance(P<0.05).In the observation group,the scores of Mazur score and ankle function were higher than those of the control group in 1,3 and 6 months after surgery,and the difference was statistically significant(P<0.05).Six months after the operarion,the total clinical efficiency of the observation group and the control group were 92.0% and 68.0%,respectively,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group and the control group were 10.0% and 28.0%,respectively,and the difference was statistically significant(P<0.05).There was no significant difference in knee morion(extension and flexion)between the two groups before treatment,but there was significant difference between the observation group and the control group after treatment(P<0.05).Conclusion Closed reduction and

关 键 词：交锁髓内钉 胫腓骨多段骨折 闭合复位 切开复位 内固定 

分 类 号：R68[医药卫生—骨科学]