不同骨折固定方法治疗开放性胫腓骨骨折合并多发性损伤的临床效果  

Clinical effects of different fracture fixation methods in the treatment of open tibiofibular fracture complicated with multiple injuries

作　　者：苗修会 张成琪 刘彦中 MIAO Xiuhui;ZHANG Chengqi;LIU Yanzhong(Emergency Department,Henan Veterans Hospital,Xinxiang 453000;No.1 Orthopaedics Department,Xinxiang First People's Hospital,Xinxiang 453000,China)

机构地区：[1]河南省荣军医院急诊科,河南新乡453000 [2]新乡市第一人民医院骨一科,河南新乡453000

出　　处：《临床医学研究与实践》2024年第25期70-73,共4页Clinical Research and Practice

摘　　要：目的分析不同骨折固定方法治疗开放性胫腓骨骨折合并多发性损伤的临床效果。方法纳入2020年1月至2022年12月收治的90例开放性胫腓骨骨折合并多发性损伤患者为研究对象,随机将其分为钢板组(45例,加压钢板固定)和髓内钉组(45例,交锁髓内钉固定)。比较两组的治疗效果。结果髓内钉组的治疗优良率显著高于钢板组(P<0.05)。髓内钉组的手术时长、卧床时长、创口愈合时长及骨折愈合时长均短于钢板组,术中出血量少于钢板组(P<0.05)。髓内钉组的并发症总发生率显著低于钢板组(P<0.05)。治疗后,髓内钉组的骨密度(BMD)、Baird-Jackson踝关节评分及胫腓骨重叠(TFO)均显著大于钢板组,内侧关节间隙(MCS)、下胫腓关节间隙(TFCS)显著小于钢板组(P<0.05)。结论相较于加压钢板固定,交锁髓内钉固定治疗开放性胫腓骨骨折合并多发性损伤效果显著,且安全性较高。Objective To analyze the clinical effects of different fracture fixation methods in the treatment of open tibiofibular fracture complicated with multiple injuries.Methods A total of 90 patients with open tibiofibular fracture complicated with multiple injuries admitted from January 2020 to December 2022 were included as the research objects.The patients were randomly divided into plate group(45 cases,compression plating fixation)and intramedullary nail group(45 cases,interlocking intramedullary nail fixation).The therapeutic effects of the two groups were compared.Results The excellent and good rate of treatment in the intramedullary nail group was significantly higher than that in the plate group(P<0.05).The operation time,bed rest time,wound healing time and fracture healing time of the intramedullary nail group were shorter than those of the plate group,and the intraoperative blood loss was less than that of the plate group(P<0.05).The total incidence of complications in the intramedullary nail group was significantly lower than that in the plate group(P<0.05).After treatment,bone mineral density(BMD),Baird-Jackson ankle score and tibiofibular overlap(TFO)in the intramedullary nail group were significantly greater than those in the plate group,and medial clear space(MCS)and lower tibiofibular clear space(TFCS)were significantly lower than those in the plate group(P<0.05).Conclusion Compared with compression plating fixation,interlocking intramedullary nail fixation has a significant effect and higher safety in the treatment of open tibiofibular fracture complicated with multiple injuries.

关 键 词：开放性胫腓骨骨折 多发性损伤 加压钢板固定 交锁髓内钉固定 

分 类 号：R681.8[医药卫生—骨科学]