骨科牵张器辅助复位经皮钢板置入内固定治疗胫骨远端骨折的效果观察  

Observation on the effect of orthopedic distractor assisted reduction and percutaneous plate implantation and internal fixation in the treatment of distal tibial fractures

作　　者：石绪才 刘坤 苗倍铭 SHI Xucai;LIU Kun;MIAO Beiming(Department of Bone hand microsurgeryⅠ,Shandong Wendeng Osteopathic Hospital,Weihai,Shandong 264400,China;不详)

机构地区：[1]山东省文登整骨医院骨手显微外科一,山东威海264400 [2]山东省文登整骨医院创伤一,山东威海264400 [3]山东省文登整骨医院骨手显微外科三,山东威海264400

出　　处：《临床外科杂志》2024年第9期966-969,共4页Journal of Clinical Surgery

摘　　要：目的探讨骨科牵张器辅助复位经皮钢板置入内固定治疗胫骨远端骨折的治疗效果。方法2019年1月~2021年1月收治的胫骨远端骨折病人120例,按照随机数字表法将其分为两组,对照组60例,采用传统手法复位下经皮钢板置入内固定治疗,观察组60例,采用骨科牵张器辅助手法复位经皮钢板置入内固定治疗。对比两组治疗效果、术中各指标、术后骨折恢复情况,比较两组并发症发生情况。结果术后12个月两组骨折愈合优良率比较差异无统计学意义(P>0.05);观察组手术时间、骨折愈合时间分别为(72.56±27.54)分钟和(16.45±4.59)周,对照组分别为(89.94±28.20)分钟和(21.15±4.54)周,观察组术中出血量为(82.27±20.14)ml,对照组为(90.12±21.48)ml,两组比较差异均有统计学意义(P<0.05);术后12个月,观察组的美国特种外科医院(HSS)膝关节评分、美国足踝矫形协会(AOFAS)踝-后足评分分别为(85.24±7.52)分和(84.58±7.29)分,对照组分别为(74.45±7.64)分和(74.56±6.38)分,两组比较差异有统计学意义(P<0.05);两组并发症总发生率比较差异无统计学意义(P>0.05)。结论胫骨远端骨折骨科牵张器辅助复位经皮钢板置入内固定治疗可减少术中出血量,缩短手术时间,术后足、踝关节功能恢复情况较好。Objective To investigate the effect of orthopedic distractor assisted reduction and percutaneous plate implantation in the treatment of distal tibial fractures.Methods 120 patients with distal tibial fractures treated in Wendeng orthopedic hospital of Shandong Province from January 2019 to January 2021 were randomly divided into two groups:the control group(60 cases,percutaneous plate implantation and internal fixation under traditional manual reduction)and the observation group(60 cases,orthopedic distractor assisted manual reduction and percutaneous plate implantation and internal fixation).The treatment effect,intraoperative indexes and postoperative fracture recovery of the two groups were compared,and the complications of the two groups were recorded and compared.Results After treatment,there was no significant difference in the excellent and good rate of fracture healing in the observation group(P>0.05);The operation time[(72.56±27.54)min]and fracture healing time[(16.45±4.59)w]of the observation group were shorter than those of the control group[(89.94±28.20)min and(21.15±4.54)w],and the amount of intraoperative bleeding in the observation group[(82.27±20.14)ml]was less than that of the control group[(90.12±21.48)ml],the differences were statistically significant(P<0.05);12 months after operation,the knee joint score of American Special Surgery Hospital(HSS)and ankle hindfoot score of American ankle Orthopedic Association(AOFAS)in the observation group[(85.24±7.52)and(84.58±7.29)]were lower than those in the control group[(74.45±7.64)and(74.56±6.38)](P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Orthopedic distractor assisted reduction and percutaneous steel plate implantation and internal fixation have good curative effect,which can effectively reduce the amount of intraoperative bleeding,shorten the operation time,and have a good recovery of foot and ankle function after operation.

关 键 词：骨科牵张器 经皮钢板置入内固定 胫骨远端骨折 

分 类 号：R687.3[医药卫生—骨科学]