新型三角锚复位钳与点式复位钳在髓内钉治疗长斜形或螺旋形胫骨远端骨折中的复位效果:一项前瞻性对比研究  

Reduction effect of triangular anchor reduction forceps and point reduction forcepsin distal tibial fracture:A prospective comparative study

作　　者：张鑫 许新忠[1] 吴钟汉 李涛 ZHANG Xin;XU Xinzhong;WU Zhonghan;LI Tao(Department of Trauma Orthopedics,Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院创伤骨科,合肥230601

出　　处：《实用医学杂志》2024年第14期1981-1987,共7页The Journal of Practical Medicine

基　　金：安徽省转化医学研究院科研基金项目(编号:2022zhyx-C47)。

摘　　要：目的比较三角锚复位钳和点式复位钳在髓内钉治疗长斜形或螺旋形胫骨远端骨折的疗效。方法前瞻性分析2019年6月至2021年3月期间在我院创伤骨科收治的58例患者资料。根据术中复位方式,分为点式复位钳复位组(n=26)和三角锚复位钳复位组(n=32)。比较两组患者的手术时间、术中透视次数、术中出血量、术后骨折复位质量、住院时间、骨折愈合时间、踝关节功能(AOFAS)评分、末次随访时疗效及并发症发生情况等。结果所有患者均参加了1年以上随访。两组患者在年龄、性别、基础疾病及受伤机制的构成比上差异无统计学意义。三角锚复位钳组患者的手术时间、术中透视次数明显低于点式复位钳组(P<0.05),而骨折复位质量则高于点式复位钳组(P<0.05),其余围术期指标的差异无显著性意义。三角锚复位钳组患者术后骨折愈合时间更短,踝关节功能也优于点式复位钳复位组(P<0.05)。两组患者各种并发症发生率比较差异无显著性意义,但总体并发症发生率三角锚复位钳组明显更低(P<0.05)。结论使用三角锚复位钳可以提高骨折复位质量,缩短骨折愈合时间,减少并发症的发生,手术时间及术中透视次数有所减少,局部未见明显感染增加,是一种有效、可靠的复位方法。Objective To compare the efficacy of triangular anchor reduction forceps and towel forceps in the treatment of long oblique or spiral distal tibial fractures.Methods The data of 58 patients admitted to the Department of Traumatic Orthopaedics in Second Affiliated Hospital of Anhui Medical University from June 2019 to March 2021 were analyzed prospectively.According to the reduction methods during operation,they were divided into point reduction forceps group(n=26)and triangle anchor reduction forceps group(n=32).The operation time,intraoperative fluoroscopy times,intraoperative blood loss,postoperative fracture reduction quality,hospital stay,fracture healing time,American orthopedic foot and ankle society(AOFAS)score,curative effect and com⁃plications at the last follow-up were compared between the two groups.Results All patients participated in the follow-up for more than one year.There was no significant difference in age,sex,basic diseases and injury mechanism between the two groups.The operation time and fluoroscopy times of patients in triangle anchor reduction group were significantly lower than those in point reduction forceps group(P<0.05),while the quality of fracture reduc⁃tion was higher than that in point reduction forceps group(P<0.05),and there was no significant difference in other perioperative indexes.The fracture healing time of patients in triangle anchor reduction group was shorter,and the ankle joint function was better than that in point reduction forceps group(P<0.05).There was no signifi⁃cant difference in the incidence of various complications between the two groups,but the overall incidence of complications in the triangle anchor reduction group was significantly lower(P<0.05).Conclusion Triangular anchor reduction forceps can improve the quality of fracture reduction,shorten the healing time of fracture,reduce the occurrence of complications,reduce the operation time and the number of fluoroscopy during operation,and there is no obvious increase in local infection.It is an effect

关 键 词：胫骨远端骨折 复位钳 髓内钉 

分 类 号：R683.42[医药卫生—骨科学]