弹性髓内钉与钢板内固定术治疗儿童胫腓骨干骨折的效果比较  

Comparison of effects of elastic intramedullary nail and steel plate internal fixation in the treatment of tibiofibularshaft fractures in children

作　　者：张运科 Zhang Yunke(The TCM Hospital of Yushan County,Yushan,Jiangxi 334700)

机构地区：[1]玉山县中医院,江西玉山334700

出　　处：《基层医学论坛》2023年第23期29-31,共3页The Medical Forum

摘　　要：目的 比较弹性髓内钉与钢板内固定术治疗儿童胫腓骨干骨折的效果。方法 以2019年7月—2021年7月间玉山县中医院收治的80例胫腓骨干骨折患儿为研究对象,按照固定方式分为弹性髓内钉组(使用弹性髓内钉固定,n=40)和钢板组(使用钢板固定,n=40),比较2组患儿手术情况,术前、术后2周、随访3个月时膝关节功能[特种外科医院评分(HSS)],术后并发症发生情况。结果 弹性髓内钉组患儿手术时间、切口愈合时间、住院时间、骨折愈合时间均短于钢板组,手术失血量少于钢板组,差异有统计学意义(P<0.05);术前和随访3个月时2组患儿的HSS得分比较差异无统计学意义(P>0.05);术后2周、随访3个月时2组患儿HSS得分均高于术前,差异有统计学意义(P<0.05);术后2周时弹性髓内钉组患儿HSS得分高于钢板组,差异有统计学意义(P<0.05);弹性髓内钉组患儿术后并发症总发生率低于钢板组,差异有统计学意义(P<0.05)。结论 在儿童胫腓骨干骨折治疗中使用弹性髓内钉固定能加快患儿术后恢复,促进膝关节功能改善且安全性可得到保证。Objective To compare the effects of elastic intramedullary nailing and steel plate internal fixation in the treatment of tibiofibular shaft fractures in children.Methods 80 children with tibiofibular shaft fractures treated in the hospital were enrolled between July 2019 and July 2021,and they were divided into elastic intramedullary nail group(fixed with elastic intramedullary nail,n=40)and steel plate group(fixed with steel plate,n=40)according to the fixation method group.The surgical status,knee function[Hospital for Special Surgery(HSS)]before surgery,at 2 weeks after surgery and at 3 months of follow-up and occurrence of postoperative complications were compared between the two groups of children.Results The surgical time,incision healing time,hospital stay and fracture healing time of children in elastic intramedullary nail group were shorter than those in steel plate group,and the surgical blood loss was less than that in steel plate group(P<0.05).There was no statistical difference in HSS score before surgery and at 3 months of follow-up(P>0.05).The HSS scores in the two groups at 2 weeks after surgery and at 3 months of follow-up were higher than those before surgery(P<0.05).The HSS score in elastic intramedullary nail group at 2 weeks after surgery was higher than that in steel plate group(P<0.05).The total incidence rate of postoperative complications was lower in elastic intramedullary nail group compared with that in steel plate group(P<0.05).Conclusion The application of elastic intramedullary nail fixation in the treatment of tibiofibular shaft fractures in children can speed up the postoperative recovery,promote the function improvement and ensure the safety.

关 键 词：儿童 胫腓骨干骨折 弹性髓内钉 钢板内固定术 疗效对比 

分 类 号：R683.42[医药卫生—骨科学]