带锁髓内钉固定治疗车祸致胫腓骨骨折的效果及对骨折愈合时间、炎症因子水平的影响  

Effect of Interlocking Intramedullary Nail Fixation in the Treatment of Tibiofibular Fractures Caused by Car Accidents and the Influence on Fracture Healing Time and Inflammatory Factor Levels

作　　者：曲军[1] 吴金海[1] 胡润武 QU Jun;WU Jinhai;HU Runwu(Emergency Medicine Department,Nanyang First People’s Hospital,Nanyang 473000,China)

机构地区：[1]南阳市第一人民医院急诊医学科,河南南阳473000

出　　处：《河南医学研究》2025年第8期1427-1430,共4页Henan Medical Research

摘　　要：目的 探讨带锁髓内钉固定治疗车祸致胫腓骨骨折的临床效果以及对患者骨折愈合时间、炎症因子水平的影响。方法 回顾性选取2021年1月至2023年1月南阳市第一人民医院收治的100例车祸致胫腓骨骨折患者资料,其中53例接受带锁髓内钉固定治疗(A组),47例接受钢板内固定治疗(B组)。对两组手术相关指标、手术前后的疼痛数字评分(NRS)、踝关节功能评分、炎症因子水平及并发症进行统计分析。结果 与B组相比,A组术后肿胀消退时间、下床活动时间、骨痂出现时间及骨折愈合时间缩短(P<0.05);术后7 d,两组NRS评分及血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均降低,美国足踝外科协会(AOFAS)评分升高,且与B组相比,A组NRS评分及血清CRP、IL-6、TNF-α水平更低,AOFAS评分更高(P<0.05);A组并发症发生率为5.66%,与B组的12.77%比较,差异无统计学意义(P>0.05)。结论 带锁髓内钉固定术可有效治疗车祸致胫腓骨骨折,其在促进患者术后康复、减轻疼痛、改善踝关节功能、降低炎症反应方面较钢板内固定术更有优势。Objective To investigate the clinical effect of interlocking intramedullary nail fixation in the treatment of tibiofibular fractures caused by car accidents,and the influence on fracture healing time and inflammatory factor levels.Methods The data of 100 patients with tibiofibular fractures caused by car accidents who were admitted to the Nanyang First People’s Hospital from January 2021 to January 2023 were analyzed retrospectively.Among them,53 patients treated with interlocking intramedullary nail fixation were included in group A,and 47 patients treated with plate fixation were included in group B.Operation-related indicators,pain numerical rating scale(NRS)scores,ankle function scores,inflammatory factor levels,and complications in the two groups were statistically analyzed.Results Compared with group B,the time for postoperative swelling regression,ambulatory time,callus appearance time,and fracture healing time were shorter in group A(P<0.05).Seven days after surgery,NRS scores and serum C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels in the two groups decreased.The American Orthopedic Foot and Ankle Society(AOFAS)scores increased.Compared with group B,the NRS score and serum CRP,IL-6 and TNF-αlevels were lower,and the AOFAS score was higher in group A(P<0.05).The incidence rates of complications in group A and group B were 5.66%and 12.77%,without statistically significant difference between groups(P>0.05).Conclusion Interlocking intramedullary nail fixation is effective in the treatment of tibiofibular fractures caused by car accidents.It has more advantages in promoting postoperative recovery,reducing pain,improving ankle function,and reducing inflammatory reactions.

关 键 词：胫腓骨骨折 骨折固定术 带锁髓内钉 愈合时间 炎症因子 

分 类 号：R683.42[医药卫生—骨科学]