山东中医杂志2018，Vol.37Issue(4)：293-298,6.DOI:10.16295/j.cnki.0257-358x.2018.04.008
三种固定方法治疗胫骨中下段骨折临床研究
Clinical Study of Three Methods for Treatment of Middle and Distal Tibial Fractures
摘要
Abstract
Objective:To compare the clinical effect of minimally invasive percutaneous plate,intramedullary nail and external fixator on treating middle and distal tibial fractures. Methods:A retrieval study was car-ried out among 54 patients with middle and distal tibial fractures in the orthopedics and traumatology de-partment of Yancheng Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,from July 1,2014 to April 30,2016. Nineteen patients were treated with minimally invasive percu taneous plate(plate group). Eighteen patients were treated with intramedullary nail(intramedullary nail group). Seventeen patients were treated with external fixator(external fixator group). The general information,duration of hospital stays,bone union time of the three groups were compared after treatment,the Olerud-Molander scores of the three groups were compared three months and six months after the surgery and the Johner Wruh scores of the three groups were compared after six months. At the same time,the effects of age,injured side,type of fractures,bone union time and classification of soft tissue injuries on the re-covery of tibia function were explored. Results:There were no statistically significant differences of age,gender,injured side,type of fractures,and classification of soft tissue injuries in the three groups (P>0.05). The duration of hospital stays of the external fixator group was (14.47±3.24 ) days which was shorter than that of the plate group with (22.84±4.39) days and the intramedullary nail group with (17.56± 4.08) days,and the differences were statistically significant(P<0.01). The bone union time of the intramedullary nail group was (13.83±1.76) weeks which was shorter than that of the plate group with (19.53±3.42) weeks and the external fixator group with(18.47±3.45) weeks,and the differences were statistically significant(P<0.01). Three months after the treatment,the Olerud-Molander score of the intramedullary nail group was the highest,and compared with those of the other two groups,the differences were statistically significant(P<0.01). There were no significant differences of Olerud-Molander scores and Johner-Wruh scores in the three groups six months after the treatment(P>0.05). The recovery of tibia function had no relationship with age, injured side and classification of soft tissue injuries ,but the type of fractures and bone union time were cor-related with the recovery of tibia function. The more complicated the type of fractures is and the longer the bone union time is,the worse the tibial function becomes at 6 months after the treatment(P<0.05). Conclu-sion:For middle and distal tibial fractures,the minimally invasive percutaneous plate,intramedullary nail and external fixator all have certain curative effect. However ,the duration of hospital stays of patients treated with external fixator is shorter and the bone union time of patients treated with intramedullary nail is short-er.关键词
胫骨中下段骨折/微创经皮锁定加压钢板/髓内钉/外固定支架/住院时间/骨折愈合时间Key words
middle and distal tibial fractures/minimally invasive percutaneous plate/intramedullary nail/external fixator/duration of hospital stays/bone union time分类
医药卫生引用本文复制引用
李正兴,韩庭良,王国军,陶宝琛,张惠法..三种固定方法治疗胫骨中下段骨折临床研究[J].山东中医杂志,2018,37(4):293-298,6.基金项目
2016年彭宝淦博士后传承工作室建设项目 （）
