L型解剖锁定钢板与胫骨远端外侧解剖锁定钢板内固定治疗胫骨中下段螺旋形骨折效果及对预后和并发症的影响  

Efficacy of Internal Fixation with L-shaped Anatomical Locking Plate or Distal Tibial Lateral Anatomical Locking Plate in Treatment of Patients with Spiral Fractures of Middle and Lower Tibia and Its Effects on Prognosis and Complications

作　　者：杨杰[1] 刘晓东[1] 刘九龙 王晓光[1] 许光辉[1] 吴朝修 袁建民 YANG Jie;LIU Xiao-dong;LIU Jiu-long;WANG Xiao-guang;XU Guang-hui;WU Chao-xiu;YUAN Jian-min(Department of Osteology,the Fifth People's Hospital of Fuyang City,Fuyang,Anhui 236000,China)

机构地区：[1]阜阳市第五人民医院骨科,安徽阜阳236000

出　　处：《临床误诊误治》2021年第8期86-90,共5页Clinical Misdiagnosis & Mistherapy

基　　金：安徽省科技攻关项目(20189PE-3)。

摘　　要：目的比较L型解剖锁定钢板与胫骨远端外侧解剖锁定钢板内固定治疗胫骨中下段螺旋形骨折效果及对预后和并发症的影响。方法回顾性分析2018年1月—2020年1月66例胫骨中下段螺旋形骨折的临床资料。按照不同类型固定材料分为观察组20例和对照组46例。观察组应用L型解剖锁定钢板固定,对照组应用胫骨远端外侧解剖锁定钢板固定。比较两组围术期指标、骨折愈合情况,以及术后1年临床疗效、踝关节功能、并发症发生情况。结果术后1年,两组临床疗效优良率和踝关节功能优良率比较差异无统计学意义(P>0.05)。两组手术时间、术中出血量、住院时间、骨痂形成时间、骨折愈合时间比较差异均无统计学意义(P>0.05),观察组切口愈合时间明显短于对照组(P<0.05)。两组切口感染、骨折延迟愈合、血管神经损伤、踝关节功能障碍发生率比较差异无统计学意义(P>0.05)。结论L型解剖锁定钢板与胫骨远端外侧解剖锁定钢板内固定治疗胫骨中下段螺旋形骨折均具有良好临床效果,能够改善踝关节功能,但应用L型解剖锁定钢板更有利于切口愈合。Objective To compare the efficacy between internal fixation with L-shaped anatomical locking plate and distal tibial lateral anatomical locking plate in treatment of patients with spiral fractures of middle and lower tibia and its effects on prognosis and complications.Methods Clinical data of 66 patients with spiral fracture of middle and lower tibia treated between January 2018 and January 2020 was retrospectively analyzed.The patients were divided into observation group(n=20)and control group(n=46)according to different types of fixation materials.Observation group was fixed with L-shaped anatomical locking plate,while control group was fixed with distal tibial lateral anatomical locking plate.The perioperative indexes,condition of fracture healing,conditions of clinical efficacy,ankle joint function and complications after operation for one year were compared between two groups.Results There were no significant differences in excellent and good rates of clinical efficacy and ankle joint function after operation for one year between two groups(P>0.05).There were no significant differences in operative duration,intraoperative volume of blood loss,length of hospitalization,callus formation time and fracture healing time between two groups(P>0.05),but healing time of incision in observation group was significantly lower than that in control group(P<0.05).There were no significant differences in incidence rates of incision infection,delayed fracture healing,vascular and nerve injuries,and ankle joint dysfunction between two groups(P>0.05).Conclusion Both internal fixation with L-shaped anatomical locking plate and distal tibial lateral anatomical locking plate may achieve good clinical efficacy in treatment of patients with spiral fracture of middle and lower tibia and improve ankle joint function,but the application of L-shaped anatomical locking plate is more conducive to incision healing.

关 键 词：胫骨骨折 L型解剖锁定钢板 外侧解剖锁定钢板 骨折固定术 内 螺旋形骨折 预后 手术后并发症 

分 类 号：R683.42[医药卫生—骨科学]