锁定钢板内固定与带锁髓内钉内固定治疗四肢长骨骨折的疗效研究  

Study on the Curative Effect of Locking Plate Internal Fixation and Interlocking Intramedullary Nail Internal Fixation in the Treatment of Long Bone Fracture of Extremities

作　　者：吴静 WU Jing(Department of Orthopedics,Putian Hanjiang Hospital,Putian 351111,China)

机构地区：[1]福建省莆田市涵江医院骨科,福建莆田351111

出　　处：《中国医药指南》2022年第36期29-33,共5页Guide of China Medicine

摘　　要：目的 观察四肢长骨骨折治疗中带锁髓内钉内固定术与锁定钢板内固定术的应用方式,比较相应的临床效果。方法 收集115例四肢长骨骨折患者作为研究对象,所有患者均来源于本院骨科2017年10月至2022年3月收治的住院患者。入组患者均临床确诊,符合手术指征,并接受手术治疗。入院后患者完善各项化验检查,综合考虑患者年龄,既往病史等因素,为患者制订手术方案。按照治疗方案的不同将患者分为两组,其中一组患者实施锁定钢板内固定治疗,病例数57例,设为锁定钢板组。另一组患者实施带锁髓内钉内固定治疗,病例数58例,设为带锁髓内钉组。结果 经组间比较与检验,两组手术时长、住院时间、骨折愈合时间均存在明显组间差异,带锁髓内钉组时间均明显短于锁定钢板组(均P <0.05)。术后1 d与术后1周分别对两组实施疼痛程度评估,可得术后1 d带锁髓内钉组的疼痛程度评分高于锁定钢板组,但差异不显著(P> 0.05);术后1周带锁髓内钉组的疼痛程度评分低于锁定钢板组(P <0.05)。带锁髓内钉组治疗总有效率96.55%,明显高于锁定钢板组(84.21%)(P <0.05)。不同的手术后,两组均出现一定的不良事件,但带锁髓内钉组总不良事件发生率为3.45%,低于锁定钢板组(17.54%)(P <0.05)。入组时锁定钢板组的Harris评分与Barthel评分均低于带锁髓内钉组,SF-36评分高于带锁髓内钉组,但组间差异经检验不明显(P> 0.05);不同的手术治疗后,带锁髓内钉组的Harris评分与Barthel评分、SF-36评分均高于锁定钢板组(P <0.05)。结论 四肢长骨骨折的手术治疗中,带锁髓内钉内固定术与锁定钢板内固定术的应用均能获得一定的效果,但带锁髓内钉内固定术的综合效果更为理想。Objective To observe the application of interlocking intramedullary nail and locking plate in the treatment of long bone fracture of extremities,and compare the corresponding clinical effects.Methods One hundred and fifteen patients with long bone fracture of extremities were collected as research objects.All patients were hospitalized in our orthopaedic department from October 2017 to March 2022.All the enrolled patients were clinically diagnosed,in line with the surgical indications,and received surgical treatment.After admission,the patient improved various laboratory tests,comprehensively considered the patient’s age,past medical history and other factors,and formulated an operation plan for the patient.The patients were divided into two groups according to the different treatment plans.One group of patients was treated with internal fixation with locking plate.The number of cases was 57,which was set as the locking plate group.The other group of patients were treated with interlocking intramedullary nail,with 58 cases interlocking intramedullary nail group.Results By comparing and testing between groups,there were significant differences in the length of operation,hospital stay,and fracture healing time between the two groups.The time in the interlocking intramedullary nail group was significantly shorter than that in the locking plate group(all P0.05);One week after operation,the pain score of the interlocking intramedullary nail group was lower than that of the locking plate group(P0.05).After different surgical treatments,the Harris score,Barthel score and SF-36 score of the interlocking intramedullary nail group were higher than those of the locking plate group(P<0.05).Conclusion In the surgical treatment of long bone fracture of extremities,the application of interlocking intramedullary nail and locking plate internal fixation can achieve certain results,but the comprehensive effect of interlocking intramedullary nail internal fixation is more ideal.

关 键 词：四肢骨折 长骨骨折 内固定术 锁定钢板 带锁髓内钉 

分 类 号：R683[医药卫生—骨科学]