闭合复位双髓内钉内固定治疗胫腓骨双骨折的疗效  

The effect of tibiofibular double fractures treated with closed reduction and double intramedullary nails

作　　者：凡福成 张保[1] 曹溢 贾其余 FAN Fu-cheng;ZHANG Bao;CAO Yi;JIA Qi-yu(Dept of Orthopaedics,the Second People′s Hospital of Hefei,Hefei,Anhui 230011,China)

机构地区：[1]合肥市第二人民医院骨科,安徽合肥230011

出　　处：《临床骨科杂志》2020年第6期875-877,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨闭合复位双髓内钉内固定治疗胫腓骨双骨折的疗效。方法采用闭合复位双髓内钉内固定治疗30例胫腓骨双骨折患者。记录切口长度、手术时间、术中出血量、住院时间、骨折愈合时间、膝踝关节功能优良率及并发症发生情况。结果切口总长度5~8 cm,手术时间1.4~2.1 h,术中出血量130~220 ml,住院时间6~14 d。患者均获得随访,时间12~14个月。骨折均愈合,时间3~8个月。1例患者术后出现切口愈合不良,切口有渗出,细菌学培养未见致病菌,经积极换药后切口愈合;1例患者术后出现骨折延迟愈合,经密切观察及指导患肢行功能康复锻炼,骨折最终愈合;无下肢深静脉血栓形成。末次随访时,根据HSS评分标准评价膝关节功能:优26例,良2例,中2例,优良率28/30;根据Johner-Wruhs评分标准评价踝关节功能:优22例,良5例,中3例,优良率27/30。结论闭合复位双髓内钉内固定治疗胫腓骨双骨折具有创伤小、术中出血量少、手术时间短、住院时间短、骨折愈合快、关节功能恢复良好、并发症少等优点。Objective To explore the treatment effect of tibiofibular double fractures treated with closed reduction and double intramedullary nails internal fixation.Methods The 30 cases of tibiofibular double fractures were treated with closed reduction and double intramedullary nails.The incision length,operation time,intraoperative blood loss,hospitalization time,fracture healing time,excellent good rate of knee-ankle joint function and complications were recorded.Results The incision length was 5~8 cm,the operation time was 1.4~2.1 h,the intraoperative bleeding volume was 130~220 ml,and the hospitalization time was 6~14 d.All patients were followed up for 12~14 months.All the fractures healed within 3~8 months.One patient had poor wound healed,exudation,no bacteria in bacteriological culture,and wound healed after active dressing change;one patient had delayed fracture healing after operation,after close observation and guidance of functional recovery exercise of the affected limb,the fracture finally healed;there was no deep vein thrombosis of the lower limb.At the last follow-up,according to the HSS scoring standard,the knee joint function was evaluated:excellent in 26 cases,good in 2,fair in 2 cases,with an excellent good rate of 28/30;according to the Johner-Wruhs scoring standard,the ankle joint function was evaluated:excellent in 22 cases,good in 5,fair in 3 cases,with an excellent good rate of 27/30.Conclusions The treatment of tibiofibular double fractures with double intramedullary nails have the advantages of less trauma,less bleeding volume during operation,short operation time,short hospitalization time,fast fracture healing,good joint function recovery and few complications.

关 键 词：胫骨骨折 腓骨骨折 髓内钉固定 闭合复位 

分 类 号：R683.42[医药卫生—骨科学] R687.33[医药卫生—外科学]