髓内针联合空心螺钉与传统钢板内固定治疗胫骨合并后踝骨折的疗效对比  

Comparison of therapeutic effects between intramedullary nail combined with hollow screw and traditional steel plate internal fixation in treatment for tibia combined with posterior ankle fractures

作　　者：李泽龙 LI Zelong(Minimally Invasive Orthopedics Department,Nanyang Traditional Chinese Medicine Hospital,Nanyang,Henan 473009,China)

机构地区：[1]南阳市中医院微创正骨科,河南南阳473009

出　　处：《中国医学工程》2025年第2期103-108,共6页China Medical Engineering

摘　　要：目的 探讨髓内针联合空心螺钉与传统钢板内固定治疗胫骨合并后踝骨折患者的临床效果差异。方法 该研究采用前瞻性随机对照研究方法,选取南阳市中医院2018年3月至2022年3月期间收治的80例胫骨合并后踝骨折患者作为研究对象,采用随机数字表法分为联合组和传统组,每组40例,其中联合组采用髓内针联合空心螺钉内固定治疗,传统组采用传统钢板内固定治疗,对比两组手术过程,手术前后外周血白细胞(WBC)、血红蛋白(Hb)、C反应蛋白(CRP)水平,手术后踝关节功能、膝关节功能差异及手术并发症情况。结果 联合组的手术时间长于传统组(P<0.05),联合组和传统组出血量、住院时间、骨折愈合时间比较,差异无统计学意义(P>0.05)。术前、术后24 h,联合组和传统组的WBC、Hb、CRP测定值比较,差异均无统计学意义(P>0.05)。术后1个月、3个月,联合组的背伸活动度、跖屈活动度高于传统组(P<0.05),联合组术后1个月的肿胀程度小于传统组(P<0.05);术后1个月、3个月,联合组膝关节行走步态、活动范围评分高于传统组(P<0.05)。联合组的手术并发症总发生率(5.00%)低于传统组(15.00%),差异无统计学意义(P>0.05)。结论 髓内针联合空心螺钉与传统钢板内固定治疗胫骨合并后踝骨折效果均可,但是前者具有术后踝关节、膝关节功能恢复更好的优势。【Objective】 To explore the clinical differences between intramedullary nail combined with hollow screw and traditional steel plate internal fixation in the treatment of patients with tibia combined with posterior ankle fractures.【Methods】 This study used a prospective randomized controlled study method,selecting 80 patients with tibia combined with ankle fractures admitted to Nanyang Traditional Chinese Medicine Hospital from March 2018 to March 2022 as the study subjects.They were randomly divided into two groups using a random number table method.Among them,40 patients in the combination group received intramedullary nail combined with hollow screw internal fixation treatment,and 40 patients in the traditional group received traditional steel plate internal fixation treatment.The surgical process,peripheral blood leukocytes(WBC),hemoglobin(Hb),C-reactive protein(CRP),postoperative ankle joint function,knee joint function,and surgical complications of the two groups of patients were compared.【Results】 The surgical time of the combination group was longer than that of the traditional group(P<0.05),and there was no statistically significant difference in bleeding volume,hospital stay,and fracture healing time between the combination group and the traditional group(P>0.05).Before surgery and 24 hours after surgery,there was no statistically significant difference in WBC,Hb,and CRP values between the combination group and the traditional group(P>0.05).One month and 3 months after surgery,the combination group had higher scores of dorsiflexion and plantar flexion activity than the traditional group(P<0.05),and the degree of swelling in the combination group was lower than that in the traditional group(P<0.05).One month and 3 months after surgery,the gait and range of motion scores of the combination group were higher than those of the traditional group(P<0.05).The total incidence of surgical complications in the combination group(5.00%) was lower than that in the traditional group(15.00%),and the differen

关 键 词：髓内针 空心螺钉 传统钢板 内固定 胫骨骨折 后踝骨折 疗效 

分 类 号：R683.42[医药卫生—骨科学]