闭合复位与有限切开复位治疗胫骨中下段关节外骨折的回顾性研究  

Retrospective study of closed fracture reduction and limited open fracturereduction in the treatment of extra-articular fractures of the middle and lower third of the tibia

作　　者：张海波[1] 何发胜[1] 何炜[1] 林蔚莘[1] 许恺[1] 陈志斌 张建新[1] 周毅强[1] ZHANG Haibo;HE Fasheng;HE Wei;LIN Weishen;XU Kai;CHEN Zhibin;ZHANG Jianxin;ZHOU Yiqiang(Department of Orthopaedic Ward,Xiamen Hospital of Traditional Chinese Medicine,Xiamen,Fujian,361009,China)

机构地区：[1]厦门市中医院骨科,福建厦门361009

出　　处：《当代医学》2023年第26期105-108,共4页Contemporary Medicine

摘　　要：目的比较闭合复位与有限切开复位治疗胫骨中下段关节外骨折的临床疗效。方法选取2013年1月至2018年12月厦门市中医院骨科收治的135例胫骨中下段关节外骨折患者作为研究对象,根据治疗方法不同分为闭合复位组(n=43)与有限切开复位组(n=92)。闭合复位组行闭合复位接骨板螺钉内固定治疗,有限切开复位组行有限切开复位接骨板螺钉内固定治疗。比较两组围手术期指标(手术时间、术中出血量、住院时间、骨折愈合时间)、骨折愈合情况及临床疗效。结果两组手术时间、术中出血量、住院时间比较差异均无统计学意义;有限切开复位组骨折愈合时间短于闭合复位组,差异有统计学意义(P<0.05)。有限切开复位组骨折正常愈合率高于闭合复位组,差异有统计学意义(P<0.05)。两组临床疗效比较差异无统计学意义。结论闭合复位与有限切开复位治疗胫骨中下段关节外骨折疗效均较好,但有限切开复位能加速骨折愈合,降低骨折延迟愈合发生率。Objective To compare the clinical efficacy of closed reduction and limited open reduction in the treatment of extra-articular frac-tures of the middle and lower third of the tibia.Methods A total of 135 patients with extra-articular fractures of the middle and lower third of the tibia admitted to the department of Orthopedics of Xiamen Hospital of Traditional Chinese Medicine from January 2013 to December 2018 were se-lected as the study subjects,they were divided into the closed reduction group(n=43)and limited open reduction group(n=92)according to differ-ent treatment methods.The closed reduction group was treated with bone plate and bone screw system by closed fracture reduction,while the limit-ed open reduction group was treated with bone plate and bone screw system by limited open fracture reduction.The perioperative indicators(opera-tive time,intraoperative blood loss,length of hospital stay,fracture healing time),fracture healing status and clinical efficacy were compared be-tween the two groups.Results There were no significant differences in operation time,intraoperative blood loss and length of hospital stay between the two groups,the fracture healing time in the limited incision group was shorter than that in the closed reduction group,and the difference was sta-tistically significant(P<0.05).The normal fracture union rate in the limited incision group was higher than that in the closed reduction group,the dif-ference was statistically significant(P<0.05).There was no significant difference in clinical efficacy between the two groups.Conclusion Both closed fracture reduction and limited open fracture reduction have satisfactory efficacy in the treatment of extra-articular fractures of the middle and lower third of the tibia,but limited open reduction can not only accelerate fracture healing but also reduce the incidence of delayed fracture healing.

关 键 词：胫骨骨折 闭合复位 有限切开复位 骨折愈合 

分 类 号：R687.3[医药卫生—骨科学]