髓内钉与锁定接骨板治疗胫骨远段骨折的临床效果比较  

Comparison of Clinical Effects of Intramedullary Nailing and Locking Plate in the Treatment of Distal Tibial Fractures

作　　者：李仁鹏 LI Renpeng(Guangshui First People’s Hospital,Guangshui 432700,China)

机构地区：[1]湖北省广水市第一人民医院,湖北广水432700

出　　处：《中国医学创新》2020年第32期50-53,共4页Medical Innovation of China

摘　　要：目的:探讨分析髓内钉与锁定接骨板治疗胫骨远段骨折的临床效果。方法:选取2017年11月-2019年10月本院收治的胫骨远段骨折患者112例为研究对象,用信封法将其分为对照组和研究组,每组56例。对照组应用髓内钉治疗,研究组应用锁定接骨板治疗。比较两组患者的术中切口长度、透视时间、出血量、术后并发症、膝踝关节功能以及骨折愈合情况。结果:研究组术中透视时间短于对照组,但术中切口长度和术中出血量略大于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为8.9%,低于对照组的28.6%,差异有统计学意义(P<0.05)。术前,两组患者K-AJFS评分比较,差异无统计学意义(P>0.05);术后半年,研究组患者K-AJFS评分高于对照组,差异有统计学意义(P<0.05)。研究组患者骨折愈合总有效率为89.3%,高于对照组73.2%,差异有统计学意义(P<0.05)。结论:将锁定接骨板应用于胫骨远段骨折的手术内固定中,避免了髓内钉固定的不稳定性,显著减少了骨折不愈合、延迟愈合等并发症的发生率,能促进膝踝关节功能的恢复,可考虑推广。Objective:To analyze the clinical effect of distal tibial intramedullary nail and locking plate in the treatment of distal tibial fracture.Method:A total of 112 cases of distal tibial and fibular fractures treated in our hospital from November 2017 to October 2019 were selected as study subjects.They were divided into control group and study group by envelope method,56 cases in each group.The control group was treated with intramedullary nail,the study group was treated with a locking plate.Intraoperative incision length,fluoroscopy time,blood volume,postoperative complications,knee and ankle function,and fracture healing were compared between the two groups.Result:The intraoperative fluoroscopy time in the study group was shorter than that in the control group,but the incision length and intraoperative blood loss were slightly larger than those in the control group,with statistically significant differences (P<0.05).The complication rate of the study group was 8.9%,lower than 28.6% of the control group,with statistically significant difference (P<0.05).There was no significant difference in K-AJFS scores between the two groups before surgery (P>0.05).Half a year after surgery,K-AJFS score in the study group was higher than that in the control group,the difference was statistically significant (P<0.05).The total effective rate of fracture healing in the study group was 89.3%,higher than 73.2% in the control group,with statistically significant difference (P<0.05).Conclusion:The application of locking plate in the internal fixation of distal tibial fractures can avoid the instability of intramedullary nail fixation,significantly reduce the incidence of nonunion,delayed union and other complications,and promote the recovery of knee and ankle joint function,can consider to popularize.

关 键 词：胫骨远端髓内钉 锁定接骨板 胫骨远段骨折 

分 类 号：R687.3[医药卫生—骨科学]