手法复位后两种固定术式治疗胫腓骨不稳定性骨折的疗效分析  

Effect analysis of two fixation mode on treament of unstable fracture of tibia and fibula after manual reduction

作　　者：王璐[1] 熊景丽 WANG Lu;XIONG Jingli(Department of Orthopedics,First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan,471000,China)

机构地区：[1]河南科技大学第一附属医院骨科,河南洛阳471000

出　　处：《实用手外科杂志》2021年第2期226-229,共4页Journal of Practical Hand Surgery

摘　　要：目的比较手法复位后带锁髓内钉固定与外固定支架固定治疗胫腓骨不稳定性骨折的临床效果。方法选择2017年4月-2019年6月接受治疗的74例胫腓骨不稳定性骨折患者进行分析研究。采用随机数字表法将患者分为带锁髓内针固定组(观察组)和外固定支架固定组(对照组),每组37例。比较两组患者手术情况、骨折愈合时间、骨痂生成时间、末次随访踝关节功能评分及并发症情况。结果观察组手术时间及术中出血量均显著大于对照组,但观察组住院时间较对照组更短(P<0.05)。观察组骨折愈合时间及骨痂生成时间均较对照组短(P<0.05)。末次随访踝关节功能评分,观察组优良率为91.89%,显著高于对照组72.97%(P<0.05)。在并发症方面对照组出现6例(16.22%),观察组出现1例(2.70%,P<0.05)。结论对于胫腓骨不稳定性骨折手法复位后,采用带锁髓内针固定可能是比外固定支架固定更好的方式。Objective To compare the effect of intramedullary interlocking nail fixation and external fixator fixation on unstable fractures of tibia and fibula after manual reduction.Methods A total of 74 patients with unstable fractures of the tibia and fibula who were treated in our hospital from April 2017 to June 2019 were selected for study.Random number table method was used to divide patients into 2 groups,37 cases in each group.The control group was fixed with external fixation after manual reduction,while the observation group was fixed with intramedullary nails.The general operation,fracture healing time,callus generation time,ankle joint function and complications of the last follow-up were compared between two groups.Results The operation time and intraoperative blood loss of the observation group were significantly greater than those of the control group,but the operation time of the observation group was shorter than the control group(P<0.05).The fracture healing time and callus formation time of observation group were shorter than those of control group(P<0.05).The excellent rate of ankle joint function in the observation group at the last follow-up was 91.89%,higher than that in the control group 72.97%(P<0.05).A total of 6 cases(16.22%)had complications in the control group,which was higher than 1 case(2.70%)in the observation group(P<0.05).Conclusion For unstable tibia and fibula fractures,intramedullary pin fixation after manual reduction may be a better method than external fixation.

关 键 词：手法复位 带锁髓内钉 胫腓骨不稳定性骨折 

分 类 号：R687.3[医药卫生—骨科学]